Abstract

Background: The mechanism of acute pancreatitis-induced hepatocellular injury is unclear. We have observed hepatocyte apoptosis in rat acute necrotizing pancreatitis. These studies were designed to determine the mediator(s) responsible for hepatocyte apoptosis and to clarify the significance of macrophages as its source. Methods: A rat sodium deoxycholate-induced pancreatitis model was used. Immunohistochemical studies for apoptosis-inducing mediators on hepatocytes were examined in the liver and on the peritoneal macrophages. The levels of transforming growth factor-β1 (TGF-β1) were also evaluated quantitatively with an enzyme-linked immunosorbent assay. Induction of apoptosis on the hepatocytes was evaluated by in situ nick-end labeling and tissue DNA fragmentation enzyme-linked immunosorbent assay. Finally, the effects of TGF-β1 neutralization and macrophage depletion were examined. Results: In the liver and the peritoneal macrophages, strong expression of TGF-β1 was detected early in the course of pancreatitis. In sodium deoxycholate-induced pancreatitis, the levels of TGF-β1 were also elevated in the plasma (9.2 ± 0.8 ng/mL), in the pancreatitis-associated ascitic fluid (11.5 ± 0.6 ng/mL), and in the liver homogenate (2.8 ± 0.3 ng/g of liver tissue). Moreover, the amount of fragmented DNA of the liver with pancreatitis was 290% ± 20% of that with a sham operation and serum alanine aminotransferase levels elevated to 248.2 ± 67.0 IU/L. TGF-β1 neutralization partly blocked the positive labeling on the nuclei of the hepatocytes, the elevation of the amounts of fragmented DNA (205% ± 10% of sham operation), and the serum alanine aminotransferase level (144.2 ± 14.9 IU/L). On the other hand, the macrophage depletion caused a marked decrease in the TGF-β1 protein level in the plasma (4.8 ± 1.2 ng/mL) or in the pancreatitis-associated ascitic fluid (8.0 ± 1.0 ng/mL). Moreover, the macrophage depletion completely inhibited the elevation of the TGF-β1 protein level in the liver homogenate (1.5 ± 0.4 ng/g of liver tissue), and thereafter decreased the amounts of the positive labeling on the nuclei of the hepatocytes and decreased the amount of fragmented DNA (120% ± 18% of sham operation) and the serum alanine aminotransferase elevation (119.2 ± 24.2 IU/L). Conclusions: In a model of sodium deoxycholate-induced pancreatitis, macrophages are responsible for pancreatitis-induced hepatocellular injury by means of apoptosis, and macrophage-derived TGF-β1 is one of the major factors inducing the hepatocyte apoptosis. (Surgery 2000;127:641-9.)

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