Lipase Levels Research Articles

Metabolomic Effects of the Dietary Inclusion of Hermetia illucens Larva Meal in Tilapia.

Black soldier fly (Hermetia illucens) larvae meal have been used as feed protein supplements in fish feed, but few researches have investigated the metabolomic effects of Hermetia illucens larvae meal supplements. Therefore, the metabolic effects on Nile tilapia were investigated by replacing 5%, 10%, and 20% of the dietary soybean meal in the basal diet with Hermetia illucens larvae meal, respectively. This study shows that 20% H. illucens larvae meal feed could promote tilapia average daily gain of upto 5.03 ± 0.18 g (mean ± SEM). It was found that the tricarboxylic acid cycle efficiency was improved by activating the enzymes of mitochondrial isocitrate dehydrogenase, NAD-malate dehydrogenase, succinate dehydrogenase, pyruvate dehydrogenase, and α-ketoglutarate dehydrogenase, which then increased the output of ATP and NADH. Furthermore, amino acid and protein biosynthesis was boosted by enhanced glutamine synthetase and glutamate synthase. In particular, GSH increased with increased H. illucens larvae meal. Unsaturated fatty acid biosynthesis was stimulated by higher levels of fatty acid synthase and acetyl CoA carboxylase. Additionally, there was no significant change in lipase levels. Thus, the higher acetyl Co-A content was primarily involved in fatty acid biosynthesis and energy metabolism. Flavor substances, such as nonanal and 2-methyl-3-furanthiol, also accumulated with the addition of H. illucens larvae meal, which increased the umami taste and meat flavor. Additionally, the flavor of tilapia was improved owing to a decrease in trimethylamine content, which causes an earthy and fishy taste. This study uncovers a previously unknown metabolic effect of dietary H. illucens larvae meal on Nile tilapia.

Role of glycodeoxycholic acid to induce acute pancreatitis in Macaca nemestrina.

BackgroundAcute pancreatitis exhibits a rapid clinical progression which makes it difficult to observe in human; hence, an experimental animal model is needed. This preliminary study performed an induction of acute pancreatitis using glycodeoxycholic acid (GDOC) in an experimental macaque model.MethodsGDOC injections (initial dose of 11.20 mg/kg) were administered in an escalating manner at specific time points. The injection was given along the bilio‐pancreatic duct, followed by measurement of vital signs, serum amylase‐lipase, TNF‐α, procalcitonin, oxidative stress parameters, and microscopic and macroscopic findings.ResultsThe results indicated that acute pancreatitis occurred following induction with low‐dose GDOC. Serum amylase and lipase levels increased with subsequent GDOC injections. Blood pressure and heart rate were elevated, indicating abdominal pain. Changes in TNF‐α, procalcitonin, and oxidative stress values showed active inflammation. We observed histologic features of pancreatitis and as the dose increased, vasodilation of the splanchnic vasculatures was observed.ConclusionsSmall dose GDOC injection in the bilio‐pancreatic duct may have a role to induce acute pancreatitis in Macaca nemestrina.

Efficacy and Safety of Thoracic Epidural Analgesia in Patients With Acute Pancreatitis: A Narrative Review.

Patients admitted to the intensive care unit with moderate to severe acute pancreatitis carry significant morbidity and mortality. A few unfortunate patients in whom the initial line of treatment fails to show clinical improvement develop multiorgan dysfunction involving lungs (adult respiratory distress syndrome), renal failure, intra-abdominal infections, sepsis, and septic shock, which ultimately leads to prolonged hospitalization and a substantial cost of treatment. The acute abdominal pain experienced by these patients is excruciating and requires multimodal analgesia. Continuous epidural analgesia has been found to provide good quality, opioid-sparing analgesia in these patients. A few studies have also demonstrated that segmental sympathectomy resulting from epidural blockade could lead to lowering of serum amylase and lipase levels improve paralytic ileus, and thus hastens the process of recovery. The present paper aims to discuss the advantages of continuous epidural analgesia in patients with acute pancreatitis of varying severity and to review the existing literature using specific keywords.

Comparative study on the therapeutic effects of bone marrow mesenchymal stem cells versus platelet rich plasma on the pancreas of adult male albino rats with streptozotocin-induced type 1 diabetes mellitus.

The optimal treatment for autoimmune type 1 diabetes mellitus (T1DM) is endogenous regeneration of the pancreatic beta-cell. This can be achieved either by transplanting bone marrow mesenchymal stem cells (BMSCs) or injecting platelet-rich plasma (PRP). Current research reviewed a T1DM model and compared the effect of BMSCs on exocrine and endocrine pancreas portions versus PRP. Rats were divided into four groups: Control group, Diabetic group (single streptozotocin dose 60 mg/kg IP), Diabetic + PRP group (PRP, 0.5 mL/kg SC twice weekly/4 weeks given to diabetic rats) and Diabetic + BMSCs group (1 mL of PKH26 labelled MSCs suspension in buffer phosphate solution, 3 × 106 cells/mL IV to diabetic rats). Glucose, amylase and lipase levels were calculated and pancreases were designed for light, electron microscopic, immunohistochemistry, morphometry and statistical analysis. Diabetic rats exhibited elevated glucose, decreased amylase and lipase compared to control rats. In addition, variable histological degenerative changes in the form of congested blood vessels have been identified with a significant increase in the mean area percentage of collagen, a significant decrease in the diameter of the islets, the number of cells in the islets of Langerhans and the number of zymogen granules. Ultrastructural findings exhibited distorted Golgi apparatus morphology, degenerated mitochondria, pyknotic nuclei, and few secretory beta-cell granules. Administration of BMSCs to diabetic group significantly increased the number of cells and diameter of Langerhans islets and the number of zymogen granules compared to Diabetic group as well as Diabetic + PRP group. BMSCs could be considered more efficient than PRP in the treatment of type 1 diabetes.

Predisposing Factors and Neurologic Outcomes of Patients with Elevated Serum Amylase and/or Lipase after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study.

This study investigated the patient outcomes, incidence, and predisposing factors of elevated pancreatic enzyme levels after OHCA. We conducted a retrospective cohort study of patients treated with targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA). Elevation of pancreatic enzyme levels was defined as serum amylase or lipase levels that were at least three times the upper limit of normal. The factors associated with elevated pancreatic enzyme levels and their association with neurologic outcomes and mortality 28 days after OHCA were analyzed. Among the 355 patients, 166 (46.8%) patients developed elevated pancreatic enzyme levels. In the multivariable analysis (odds ratio, 95% confidence interval), initial shockable rhythm (0.62, 0.39–0.98, p = 0.04), time from collapse to return of spontaneous circulation (1.02, 1.01–1.04, p < 0.001), and history of coronary artery disease (1.7, 1.01–2.87, p = 0.046) were associated with elevated pancreatic enzyme levels. After adjusting for confounding factors, elevated pancreatic enzyme levels were associated with neurologic outcomes (5.44, 3.35–8.83, p < 0.001) and mortality (3.74, 2.39–5.86, p < 0.001). Increased pancreatic enzyme levels are common in patients treated with TTM after OHCA and are associated with unfavorable neurologic outcomes and mortality at 28 days after OHCA.

A Rare Cause of Hemoperitoneum

A Rare Cause of Hemoperitoneum

Role of fluid optimization in Acute Pancreatitis

Background: Acute Pancreatitis is one of the commonest cause for admission to the surgical emergency ward. In view of this, fluid management remains the main stay of treatment in the immediate period. Optimal fluid management avoids further complications including Organ failure and Pancreatic Necrosis. Objective: Proper management of the Acute Pancreatitis is very essential, early identification of the patients and Optimization in Fluid remains the main stay of treatment. To understand the pathophysiology of fluid depletion in Acute Pancreatitis. Material and Methods: Records of patients who were admitted with Acute Pancreatitis in Mandya Institute of Medical Sciences, Mandya between June 2018 and May 2019 (1-year period) were studied and analysed. 76 acute pancreatitis cases were admitted during this period. Those diagnosed with acute pancreatitis on the basis of epigastric pain, serum amylase and serum lipase levels more than 3 times normal were subjected to the investigations and fluid management was analysed at the time of admission and after 48hours. Results: In our study, out of 76 cases admitted with the diagnosis of Acute Pancreatitis 22% had Severe acute pancreatitis, 72% affected were males,60% of the total were in 4th decade, alcohol was the most common aetiology 55%, followed by biliary pancreatitis 35% and idiopathic 10%. Patients managed with optimal fluid recovery rate was 87% in Mild Acute Pancreatitis, 67% in moderately severe Acute Pancreatitis and 54% in Severe Acute Pancreatitis. Conclusion: Optimal Fluid management remains the main stay of therapy in Acute Pancreatitis. Early identification of the disease and optimal fluid management reduces the mortality and morbidity in Acute Pancreatitis.

Adenosine Kinase Inhibition Prevents Severe Acute Pancreatitis via Suppressing Inflammation and Acinar Cell Necroptosis.

Background: Inflammatory disorder and acinar cell death contribute to the initiation and progression of severe acute pancreatitis (SAP). Adenosine kinase (ADK) has potential effects on both inflammation and cell death. However, the role of ADK in SAP remains to be explored. Methods: To establish an experimental SAP model, male C57BL/6 mice were intraperitoneally injected with cerulein (50 μg/kg, seven doses at hourly intervals) and LPS (10 mg/kg, at the last cerulein injection). For ADK inhibition, ABT702 (1.5 mg/kg) was intraperitoneally injected 1 h before cerulein treatment. The pancreas and serum were collected and analyzed to determine the severity of pancreatic injury and explore the potential pathophysiological mechanisms. Pancreatic acinar cells (AR42J) were used to explore the in vitro effects of ADK inhibition on cerulein–induced inflammation and necroptotic cell death. Results: ADK inhibition notably attenuated the severity of SAP, as indicated by the decreased serum amylase (7,416.76 ± 1,457.76 vs. 4,581.89 ± 1,175.04 U/L) and lipase (46.51 ± 11.50 vs. 32.94 ± 11.46 U/L) levels and fewer pancreatic histopathological alterations (histological scores: 6.433 ± 0.60 vs. 3.77 ± 0.70). MOMA-2 and CD11b staining confirmed that ADK inhibition prevented the infiltration of neutrophils and macrophages. The phosphorylation of nuclear factor-κB (NF-κB) was also reduced by ADK inhibition. ADK inhibition markedly limited the necrotic area of the pancreas and prevented the activation of the necroptotic signaling pathway. Endoplasmic reticulum (ER) stress was activated in the pancreas using the SAP model and cerulein–treated AR42J cells whereas ADK inhibition reversed the activation of ER stress both in vivo and in vitro. Moreover, the alleviating effects of ADK inhibition on ER stress, inflammation, and cell necroptosis were eliminated by the adenosine A2A receptor antagonist. Conclusion: ADK inhibition reduced inflammation and necroptotic acinar cell death in SAP via the adenosine A2A receptor/ER stress pathway, suggesting that ADK might be a potential therapeutic target for SAP.

Role of CaMK II in pancreatic injury in mice with severe acute pancreatitis

To investigate the expression of Ca2+/calmodulin-dependent protein kinase II (CaMK Ⅱ) in pancreatic tissues of mice with severe acute pancreatitis (SAP) and explore the protective effect of KN93, a CaMK Ⅱ inhibitor, against pancreatic injury in SAP and the possible mechanism. Thirty-six healthy male C57 mice were randomly divided into sham operation group, SAP group, KN93 group and SAP + KN93 group (n=9). Serum and pancreatic tissue samples were collected 24 h after modeling. The pathological changes in the pancreatic tissues were observed using HE staining. Serum lipase and amylase activities and the levels of inflammatory factors were detected using ELISA. Western blotting was used to detect the expressions of CaMK Ⅱ, p-CaMK Ⅱ, p-NF-κB, MAPK and p-MAPK in mouse pancreas. Compared with those in sham operation group, the expressions of p-CaMK Ⅱ, p-NF-κB and p-MAPK were significantly increased in SAP group (P < 0.05). KN93 treatment obviously alleviated pathological injuries of the pancreas in SAP mice, and significantly lowered serum levels of lipase, amylase and inflammatory factors (TNF-α and IL-6) and phosphorylation levels of NF-κB, ERK and MAPK proteins (P < 0.05). The activity of CaMK Ⅱ is significantly increased in the pancreatic tissue of SAP mice. KN93 can alleviate pancreatic injury and inflammation in SAP mice possibly through the ERK/MAPK signaling pathway.

Effects of Dietary Arginine on Growth Performance, Digestion, Absorption Ability, Antioxidant Capability, Gene Expression of Intestinal Protein Synthesis, and Inflammation-Related Genes of Triploid Juvenile Oncorhynchus mykiss Fed a Low-Fishmeal Diet

In this study, the effects of arginine on growth, serum antioxidant levels, intestinal digestion physiology, intestinal protein synthesis, and expression of inflammatory-related genes of triploid juvenile rainbow trout (Oncorhynchus mykiss) were investigated. Five diets containing 0.86%, 1.65%, 2.10%, 2.85%, and 3.50% arginine were fed to satiation to triplicate groups of 30 fish per tank for 8 weeks. The results showed that the weight gain rate, specific growth rate, and protein efficiency ratio significantly increased. The optimal dietary arginine requirement was 2.48% (5.97% of dietary protein) based on quadratic regression analysis between specific growth rate and dietary arginine content. There were no significant differences in crude lipid and ash content. Moisture significantly decreased, and crude protein content significantly increased ( P &lt; 0.05 ). Superoxide dismutase, catalase, and lysozyme levels in serum and the liver first significantly increased and then decreased with the level of arginine compared to the control group ( P &lt; 0.05 ), while the malondialdehyde level significantly decreased. Intestinal lipase and amylase levels significantly increased, but there was no significant difference in trypsin level ( P &gt; 0.05 ). The muscular layer thickness and villus width foregut in the 2.85% group were significantly increased. TOR at 2.86% and IGF-1 and S6K1 at 2.11% reached the maximum level, and IL-1β, IL-6, and IL-8 showed a decreasing trend with their lowest levels in the 3.50% and 2.85% groups. The expression of TNF-α first decreased and then increased with the arginine level. Both TGF-β and IL-10 expression first decreased and then increased with the level of arginine and reached the maximum value in the 2.85% group. NF-κB showed an opposite trend and reached the lowest value in the 3.50% group. In conclusion, dietary arginine has a significant effect on growth, serum antioxidant capability, digestion physiology, immunity, digestion, and absorption of nutrients in triploid O. mykiss, and the optimum requirement is 2.48% fed a low-fishmeal diet.

Paeonol protects against acute pancreatitis by inhibiting M1 macrophage polarization via the NLRP3 inflammasomes pathway

The excessive inflammatory response mediated by macrophage is one of the key factors for the progress of acute pancreatitis (AP). Paeonol (Pae) was demonstrated to exert multiple anti-inflammatory effects. However, the role of Pae on AP is not clear. In the present study, we aimed to investigate the protective effect and mechanism of Pae on AP in vivo and vitro. In the caerulein-induced mild acute pancreatitis (MAP) model, we found that Pae administration reduced serum levels of amylase, lipase, IL-1β and IL-6 and alleviated the histopathological manifestations of pancreatic tissue in a dose-dependent manner. And Pae decrease the ROS generated, restore mitochondrial membrane potential (ΔΨm), inhibit M1 macrophage polarization and NLRP3 inflammasome in bone marrow-derived macrophages (BMDMs) in vitro. In addition, specific NLRP3 inhibitor MCC950 eliminated the protective effect of Pae on AP induced by caerulein in mice. Correspondingly, the inhibitory effect of Pae on ROS generated and M1 polarization was not observed in BMDMs with MCC950 in vitro. Taken together, our datas for the first time confirmed the protective effects of Pae on AP via the NLRP3 inflammasomes Pathway.

Optimized Hemolysin Type 1 Secretion System in Escherichia coli by Directed Evolution of the Hly Enhancer Fragment and Including a Terminator Region.

Type 1 secretion systems (T1SS) have a relatively simple architecture compared to other classes of secretion systems and therefore, are attractive to be optimized by protein engineering. Here, we report a KnowVolution campaign for the hemolysin (Hly) enhancer fragment, an untranslated region upstream of the hlyA gene, of the hemolysin T1SS of Escherichia coli to enhance its secretion efficiency. The best performing variant of the Hly enhancer fragment contained five nucleotide mutations at five positions (A30U, A36U, A54G, A81U, and A116U) resulted in a 2‐fold increase in the secretion level of a model lipase fused to the secretion carrier HlyA1. Computational analysis suggested that altered affinity to the generated enhancer fragment towards the S1 ribosomal protein contributes to the enhanced secretion levels. Furthermore, we demonstrate that involving a native terminator region along with the generated Hly enhancer fragment increased the secretion levels of the Hly system up to 5‐fold.

Acute pancreatitis following Pfizer-BioNTech COVID-19 vaccine

The coronavirus disease of 2019 (COVID-19) discovered in China in early December 2019. The Saudi Food and Drug Authority approved the registration of the Pfizer-BioNTech COVID-19 vaccine in Saudi Arabia on December 10, 2020, and on May 10, 2021, Pfizer-BioNTech was given emergency authorization for use of the vaccine in children aged 12 to 15 years. Saudi Arabia’s Ministry of Health started the vaccination phase for ages 12 to 18 years for the Pfizer-BioNTech COVID-19 vaccine on June 27, 2021. An insulin-dependent diabetic 15-year-old female patient admitted to the medical ward diagnosed with acute pancreatitis nine days after being administered her first dose of the Pfizer-BioNTech COVID-19 vaccine. She presented with an amylase level of 340 U/L, lipase level of 937 U/L. She was discharged after eight days of hospitalization with no complications. Medical investigations were unable to link the diagnosis to any known etiology. Medical journals have reported numerous cases of acute pancreatitis in the adult population after Pfizer-BioNTech COVID-19 vaccination. We believe that our case is the first to present with acute pancreatitis after the first dose of the Pfizer-BioNTech COVID-19 vaccine in a teenager population.

Normal Lipase Pancreatitis: A Case Report

Acute pancreatitis is a serious and potentially fatal condition, caused by the pancreas self-digesting with its own accidentally activated enzymes. its diagnosis is based on a combination of clinical, biological and radiological evidence. The absence of lipase elevation during acute pancreatitis is extremely rare and can sometimes make the diagnosis difficult and therefore delay the treatment. We will report the case of a 27-year-old female patient, with no previous history of the disease, who consulted us for acute abdominal pain, and whose diagnosis, after an etiological investigation, was pancreatitis with normal lipase levels.

Systems Thinking

Systems Thinking

Early endoscopic transpapillary drainage through the minor papilla in the treatment of acute pancreatitis.

To explore the feasibility, safety, and efficacy of endoscopic transpapillary drainage through the minor papilla in the treatment of acute pancreatitis (AP). We retrospectively evaluated the safety and efficacy of endoscopic transpapillary drainage via the minor papilla among AP patients who were treated in our hospital from September 2018 to March 2020. The present study included 18 patients (12 males and 6 females). All patients successfully received endoscopic transpapillary drainage via the minor papilla and were discharged upon recovery. No patient died, received ICU treatment, or had endoscopic operation-related complications. Two patients (11.11%) received additional abdominal paracentesis due to local complications. Fifteen patients (83.33%) resumed oral feeding within 3 days. The postoperative 24-hour leukocyte level, APACHE II score, serum amylase level, and lipase level significantly decreased compared with those at admission. The median hospitalization stay was 5 (3.75-9) days. The median hospitalization cost was 25,123.82 (22,942.50-43,874.68) RMB. The patients were followed up at 6-24 months, during which 4 patients (22.22%) had recurrence. Two patients had recurrence after pancreatic duct removal and other 2 patients in the period of carrying ducts. Early endoscopic transpapillary drainage via the minor papilla in cases of difficult cannulation or stenting via the major papilla is safe and effective in the treatment of AP, and is worthy of further popularization.

Urinary amylase levels in the diagnosis of acute pancreatitis: a prospective case control study

Background: Serum amylase has a short biological half-life and returns to normal levels within short time. Thus it’s quite conflicting in the diagnosis of acute pancreatitis, particularly in patients with mild acute pancreatitis. Therefore, present study investigates the urinary amylase levels in the diagnosis of acute pancreatitis.Methods: The present prospective study was conducted on 100 patients, 50 with acute pancreatitis and 50 normal subjects in the departments of General Surgery and our surgical hospital. All patients were examined by clinically, biochemical and radiological investigations and diagnosed acute pancreatitis. Serum amylase levels, serum lipase levels and urinary amylase levels were estimated in both groups: cases and controls. The sensitivity and specificity of serum amylase, serum lipase and urinary amylase levels were established after comparing their values in cases and controls.Results: The preponderance of the patients was aged between 21 and 50 years. Increase the serum amylase, lipase and urinary amylase mean values of patients with acute pancreatitis were observed statistically significant (p&lt;0.001). Serum amylase had the highest sensitivity (100%) and serum lipase had the highest specificity (96.53%). The sensitivity and specificity of urinary amylase was found to be 97.25% and 91.47% respectively. On ROC curve analysis, the area under the curve for serum amylase, serum lipase and urinary amylase was found to be 0.845, 0.945 and 0.934.Conclusions: We conclude that urinary amylase is a convenient and a more sensitive test for diagnosis of acute pancreatitis.

A rare case of unusual presentation of acute necrotising pancreatitis as a presenting feature of dengue haemorrhagic fever in a child

Background: Dengue fever is an acute viral infection seen commonly in developing countries. Its presentation varies in children starting from mild illness to severe complications. Acute necrotising pancreatitis is a serious form of pancreatitis which is a very rare entity in children. Here we are presenting a rare case of unusual presentation of acute necrotising pancreatitis as a presenting feature of dengue fever. Case details: A 15 years male child presented with history of pain, distension of abdomen and vomiting. Patient had history of fever off and on since one month. Per abdomen examination showed ascites, hepatomegaly. Dengue NS1 antigen and dengue serology IgM was positive. Serum amylase level and lipase level were 1540 U/Land 960 U/L respectively. Contrast enhanced CT scan and MRCP showed bulky pancreas with decreased enhancement with ascites. Patient was managed conservatively with intravenous fluids, antibiotics and octreotide and patient was discharged successfully. Acute necrotising pancreatitis as a presenting feature of dengue fever has not been reported in children to the best of my knowledge. Conclusion: Clinical presentation of dengue fever varies but when patient presents with pain in abdomen, vomiting and fever then acute pancreatitis should be ruled out. In such patient clinical suspicion is important and timely intervention may lead to complete recovery and good outcome.

Reducing Phlebotomy, Length of Stay, Cost: Development of a Blunt Abdominal Trauma Pathway in a Level I, Pediatric Trauma Center.

Blunt abdominal trauma (BAT) is a leading cause of morbidity in children with higher hemodynamic stabilities when compared with adults. Pediatric patients with BAT can often be managed without surgical interventions; however, laboratory testing is often recommended. Yet, laboratory testing can be costly, and current literature has not identified appropriate pathways or specific tests necessary to detect intra-abdominal injury after BAT. Therefore, the present study evaluated a proposed laboratory testing pathway to determine if it safely reduced draws of complete blood counts, coagulation studies, urinalysis, comprehensive metabolic panels, amylase and lipase levels orders, emergency department (ED) length of stay, and cost in pediatric BAT patients. A retrospective review of levels I, II, and III BAT pediatric patients (n = 329) was performed from 2015 to 2018 at our level I, pediatric trauma center. Patients were then grouped based on pre-post pathway, and differences were calculated using univariate analyses. After implementation of the pathway, there was a significant decrease in the number of complete blood counts, coagulation studies, urinalysis, comprehensive metabolic panels, amylase, and lipase levels orders ( P < 0.05). Postpathway patients had lower average ED lengths of stay and testing costs compared with the pre pathway patients ( P < 0.05). There was no increase in rates of return to the ED within 30 days, missed injuries, or readmissions of patients to the ED. Results displayed that the adoption of a laboratory testing pathway for BAT patients reduced the number of laboratory tests, ED length of stay, and associated costs pediatric patients without impacting quality care.

Triptolide Suppresses NF-κB-Mediated Inflammatory Responses and Activates Expression of Nrf2-Mediated Antioxidant Genes to Alleviate Caerulein-Induced Acute Pancreatitis.

Triptolide (TP), the main active ingredient of Tripterygium wilfordii Hook.f., displays potent anti-inflammatory, antioxidant, and antiproliferative activities. In the present study, the effect of TP on acute pancreatitis and the underlying mechanisms of the disease were investigated using a caerulein-induced animal model of acute pancreatitis (AP) and an in vitro cell model. In vivo, pretreatment with TP notably ameliorated pancreatic damage, shown as the improvement in serum amylase and lipase levels and pancreatic morphology. Meanwhile, TP modulated the infiltration of neutrophils and macrophages (Ly6G staining and CD68 staining) and decreased the levels of proinflammatory factors (TNF-α and IL-6) through inhibiting the transactivation of nuclear factor-κB (NF-κB) in caerulein-treated mice. Furthermore, TP reverted changes in oxidative stress markers, including pancreatic glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA), in acute pancreatitis mice. Additionally, TP pretreatment inhibited intracellular reactive oxygen species (ROS) levels via upregulated nuclear factor erythroid 2-related factor 2 (Nrf2) expression and Nrf2-regulated redox genes expression (HO-1, SOD1, GPx1 and NQO1) in vitro. Taken together, our data suggest that TP exert protection against pancreatic inflammation and tissue damage by inhibiting NF-κB transactivation, modulating immune cell responses and activating the Nrf2-mediated antioxidative system, thereby alleviating acute pancreatitis.