The role of apoptosis of alveolar type Ⅱ epithelial cells in the pathogenesis of severe acute pancreatitis lung injury and the intervention of ulinastatin
Objective To explore the role of type Ⅱ alveolar epithelial cell apoptosis in the pathogenesis of severe acute pancreatitis(SAP)and analyze the intervention effect of ulinastatin.Methods 42 healthy rats were randomly divided into 3 groups:sham operation group,model group and ulinastatin intervention group,with 14 rats in each group.The sap rat model was established by injecting sodium deoxycholate into the medial pancreaticobiliary duct of duodenal papilla of rats.The rats in sham operation group only opened the abdominal cavity of rats,gently flipped the pancreas and then closed the abdominal cavity.The rats in ulinastatin intervention group were injected with ulinastatin after modeling.The pathological changes of lung tissue and pancreas tissue and the differences of re-lated indexes were analyzed.Results Compared with the sham surgery group,the levels of TNF-α,AMY and MDA in SAP group and the ulinastatin intervention group were significantly increased(P＜0.05).Compared with the SAP group,the levels of TNF-α,AMY and MDA in ulinastatin intervention group were significantly decreased(P＜0.05).The lung wet/dry ratio of the sham surgery group,SAP group,and ulinastatin intervention group were 3.62± 0.56,6.48±0.77,and 4.69±0.63,respectively.The blood gas indicators PaCC2 and PaO2 were(31.25±1.03)mmHg,(106.52±2.03)mmHg,(48.67±2.01)mmHg,(73.57±2.44)mmHg,and(35.22±1.32)mmHg,(90.22±3.01)mmHg,respectively.The SAP group and ulinastatin intervention group showed a significant increase in lung wet/dry ratio and PaCO2,while PaO2 decreased significantly.Compared with the SAP group,the ulinastatin intervention group showed lower lung wet/dry ratio and PaCO2,while PaO2 was higher(P＜0.05).The apoptosis rate[(3.58± 0.57)％]and Ca2+concentration[(34.52±2.35)％]of alveolar type Ⅱ epithelial cells in the sham surgery group were significantly lower than those in the SAP group[(29.67±4.52)％]and Ca2+concentration[(82.66±4.66)％],as well as the apoptosis rate[(14.62±3.67)％]and Ca2+concentration[(46.77±5.02)％]in the ulinastatin interven-tion group.The apoptosis rate and Ca2+concentration of alveolar type Ⅱ epithelial cells in the ulinastatin intervention group were significantly lower than those in the SAP group(P＜0.05).The expression of Caspasee-8 and Bax mRNA in rats of the sham surgery group was significantly lower than that of the SAP group and the ulinastatin intervention group.The expression of Caspasee-8 and Bax mRNA in rats of the ulinastatin intervention group was significantly low-er than that of the SAP group(P＜0.05).The damage of mitochondrial cells in SAP lung injury rats is significant,and ulinastatin has a significant effect on reducing the number of mitochondrial cell damage.Conclusion Apoptosis of alveolar type Ⅱ epithelial cells is involved in the mechanism of SAP lung injury.TNF-α,Amy,MDA,Caspase-8 and Bax mRNA play an important role in the mechanism of SAP lung injury.Ulinastatin intervention is beneficial to alleviate SAP lung injury and control the progress of the disease.
Severe acute pancreatitisHung injuryApoptosis of alveolar type Ⅱ epithelial cellsUlinastatinRat
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