Pathogenesis of bile-induced acute pancreatitis in the dog

Abstract

A series of recent observations on different aspects of the chemistry and metabolic actions of bile have led us to investigate the possibility that bile may induce pancreatitis through the physicochemical detergent properties of its salts. To determine the relative importance of proteolytic enzymes on the one hand, and the detergent action of bile on the other, in the pathogenesis of bile-induced experimental pancreatitis in the dog, the early morphologic changes (1–30 min) produced by the intraductal injection of the following substances were investigated: (1) autogenous bile; (2) bile salt; (3) an anionic detergent, sodium lauryl sulfate (SLS); (4) trypsin; (5) a cationic detergent, cetrimide; (6) a neutralized mixture of SLS and cetrimide; and (7) saline solution. Autogenous bile, bile salts and SLS produce pancreatitis of similar morphologic appearance, characterized by punched-out areas of coagulation necrosis. Trypsin-induced pancreatitis was distinctly different from that produced by bile, bile salts and SLS. In trypsin pancreatitis, irregular areas of necrosis and hemorrhage were seen. Inactivation of the detergent activity of SLS by mixing it with the cationic detergent, cetrimide, reduced the capacity of SLS to induce pancreatitis similar to that induced by bile and bile salts. These data seem to indicate that the early phases of bile-induced pancreatitis in our experiments are unlikely to result from the liberation of trypsin, but are related instead to the detergent activity of bile salts.