Open AccessGut Barrier Dysfunction Induced by Aggressive Fluid Resuscitation in Severe Acute Pancreatitis is Alleviated by Necroptosis Inhibition in Rats
Author(s) -
Qing-Rui Cui,
Yihong Ling,
Sijian Wen,
Ke-Xuan Liu,
Yuke Xiang,
Wenjing Yang,
Jiantong Shen,
Yunsheng Li,
Bao-Long Yuan,
Wenqi Huang
Publication year - 2019
Publication title -
shock
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.095
H-Index - 117
eISSN - 1540-0514
pISSN - 1073-2322
DOI - 10.1097/shk.0000000000001304
Subject(s) - resuscitation , acute pancreatitis , medicine , necroptosis , multiple organ dysfunction syndrome , systemic inflammatory response syndrome , organ dysfunction , pancreatitis , intestinal ischemia , ischemia , reperfusion injury , anesthesia , biology , sepsis , apoptosis , programmed cell death , biochemistry
Fluid resuscitation is the first-line antishock treatment in severe acute pancreatitis (SAP). Currently, although mentions of complications related to aggressive fluid resuscitation are very frequent, a lack of proper handling of complications remains. One of the most important complications is intestinal barrier injury, including intestinal ischemia-reperfusion injury following aggressive fluid resuscitation. Once injured, the intestinal barrier may serve as the source of additional diseases, including systemic inflammatory response syndrome and multiple organ dysfunction syndrome, which aggravate SAP. This study focused on the underlying mechanisms of gut barrier dysfunction in rats induced by aggressive fluid resuscitation in SAP. This study further indicated the important role of necroptosis in intestinal barrier injury which could be relieved by using necroptosis-specific inhibitor Nec-1 before aggressive fluid resuscitation, thus reducing intestinal barrier damage. We also found pancreas damage after intestinal ischemia/reperfusion challenge and indicated the effects of high mobility group protein B1 in the vicious cycle between SAP and intestinal barrier damage.