PPAR-Alpha Agonist Fenofibrate Combined with Octreotide Acetate in the Treatment of Acute Hyperlipidemia Pancreatitis.

Wen Bao,Nan Wang,Jie Lu,Wei Han,Rui Kong,Antonio Brunetti

doi:10.1155/2021/6629455

Abstract

At present, there are more and more patients with acute hypertriglyceridemia pancreatitis in clinical practice. Common treatment measures include fasting and water withdrawal, fluid resuscitation, and somatostatin. In recent years, studies have pointed out that the PPARa agonist fenofibrate may help improve the condition of such patients. Therefore, through clinical research and analysis, we reported for the first time that fenofibrate combined with octreotide acetate has a more excellent effect in the treatment of patients with acute hypertriglyceridemia pancreatitis, and from the perspective of signal pathways, we revealed that the combination of the two drugs has an effect on NF-κB P65. The synergistic inhibitory effect proves that the combined treatment is beneficial to control inflammation, protect liver function, and improve the prognosis of patients. It is worthy of clinical promotion.

Highlights

According to statistics, the incidence of hypertriglyceridemia in the social population is increasing year by year, and the diseased population is showing a younger trend
Peroxisome proliferatoractivated receptor (PPARa) is a type of transcription factor activated by ligands, which belongs to the nuclear hormone receptor superfamily
Fenofibrate inhibits the release of interleukin 1β and pro-IL-18 from pancreatic acinar cells, thereby reducing the expression of chemokines and proinflammatory cytokines, such as IL-1β, IL-6, and tumor necrosis factor-alpha (TNFα), and may initiate the programmed cell death pathway, prompting local and systemic anti-inflammatory responses [11]

Summary

Introduction

The incidence of hypertriglyceridemia in the social population is increasing year by year, and the diseased population is showing a younger trend. The possible pathogenesis is that lipid globule microembolism affects pancreatic microcirculation and pancreatin breaks down triglycerides to cause toxic fatty acids to directly damage acinar cells. These can activate important pivotal molecules such as NF-κB [3], activator protein 1 (AP-1) [4], and signal transducers and activators of transcription (STATs), thereby increasing the expression of inflammatory mediators downstream of the signaling pathway, such as TNF-α, IL-6, IL-1, and reactive oxygen radicals [5]. The PPARa agonist fenofibrate is currently the most commonly used clinically for lowering triglycerides It can significantly reduce the level of apolipoprotein C-III, thereby reducing the synthesis of very-low-density lipoprotein and lowdensity lipoprotein, and accelerating the metabolism of TG [10].

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Conclusion