Basic Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2020; 26(1): 35-54
Published online Jan 7, 2020. doi: 10.3748/wjg.v26.i1.35
Abdominal paracentesis drainage ameliorates myocardial injury in severe experimental pancreatitis rats through suppressing oxidative stress
Yi Wen, Hong-Yu Sun, Zhen Tan, Ruo-Hong Liu, Shang-Qing Huang, Guang-Yu Chen, Hao Qi, Li-Jun Tang
Yi Wen, Hong-Yu Sun, Zhen Tan, Ruo-Hong Liu, Shang-Qing Huang, Guang-Yu Chen, Li-Jun Tang, Department of General Surgery and Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu 610083, Sichuan Province, China
Hao Qi, Department of Dermatology, The Air Force Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Author contributions: Wen Y, Sun HY and Tan Z contributed equally to this work; Tang LJ designed the experiments; Wen Y, Tan Z, Liu RH and Huang SQ performed the experiments; Wen Y, Sun HY and Tan Z analyzed the data; Chen GY and Hao Q prepared and finished all the figures; Wen Y and Tan Z drafted the manuscript; Tang LJ and Sun HY refined and edited the manuscript; Tang LJ supervised the study.
Supported by National Natural Science Foundation of China, No. 81772001; National Clinical Key Subject of China, No. 41792113; and Technology Plan Program of Sichuan Provence, No. 2015SZ0229, No. 2016HH0067, No. 2018JY0041 and No. 2019YJ0277.
Institutional review board statement: This study was approved by the Institutional Review Board of Chengdu Military General Hospital.
Institutional animal care and use committee statement: All animal protocols were approved by Animal Welfare law of Chengdu Military General Hospital, Chengdu, China, No. A20170312004.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this study.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: In the manuscript, the ARRIVE Guidelines have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Li-Jun Tang, MD, PhD, Chief Doctor, Professor, Chief of Surgery, Department of General Surgery and Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, No. 270 Rongdu Road, Jinniu District, Chengdu 610083, Sichuan Province, China. tanglj2016@163.com
Received: September 26, 2019
Peer-review started: September 26, 2019
First decision: November 4, 2019
Revised: December 6, 2019
Accepted: December 13, 2019
Article in press: December 13, 2019
Published online: January 7, 2020
Abstract
BACKGROUND

Abdominal paracentesis drainage (APD) is a safe and effective strategy for severe acute pancreatitis (SAP) patients. However, the effects of APD treatment on SAP-associated cardiac injury remain unknown.

AIM

To investigate the protective effects of APD on SAP-associated cardiac injury and the underlying mechanisms.

METHODS

SAP was induced by 5% sodium taurocholate retrograde injection in Sprague-Dawley rats. APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after SAP induction. Morphological staining, serum amylase and inflammatory mediators, serum and ascites high mobility group box (HMGB) 1, cardiac-related enzymes indexes and cardiac function, oxidative stress markers and apoptosis and associated proteins were assessed in the myocardium in SAP rats. Nicotinamide adenine dinucleotide phosphate oxidase activity and mRNA and protein expression were also examined.

RESULTS

APD treatment improved cardiac morphological changes, inhibited cardiac dysfunction, decreased cardiac enzymes and reduced cardiomyocyte apoptosis, proapoptotic Bax and cleaved caspase-3 protein levels. APD significantly decreased serum levels of HMGB1, inhibited nicotinamide adenine dinucleotide phosphate oxidase expression and ultimately alleviated cardiac oxidative injury. Furthermore, the activation of cardiac nicotinamide adenine dinucleotide phosphate oxidase by pancreatitis-associated ascitic fluid intraperitoneal injection was effectively inhibited by adding anti-HMGB1 neutralizing antibody in rats with mild acute pancreatitis.

CONCLUSION

APD treatment could exert cardioprotective effects on SAP-associated cardiac injury through suppressing HMGB1-mediated oxidative stress, which may be a novel mechanism behind the effectiveness of APD on SAP.

Keywords: Abdominal paracentesis drainage, Severe acute pancreatitis, Myocardial injury, High mobility group box 1, Nicotinamide adenine dinucleotide phosphate oxidase, Oxidative stress

Core tip: In the present study, we provided the first evidence that abdominal paracentesis drainage (APD) treatment exerts beneficial effects on severe acute pancreatitis-associated cardiac injury. Our key findings are that (1) APD treatment decreases the serum levels of cardiac enzymes and improves cardiac function; (2) APD treatment alleviates cardiac oxidative stress and accompanied cardiomyocyte apoptosis; and (3) The beneficial effects of APD treatment in ameliorating severe acute pancreatitis-associated cardiac injury are due to the inhibition of oxidative damage via downregulating high mobility group box 1-mediated nicotinamide adenine dinucleotide phosphate oxidase expression. Our data manifest that APD is a promising treatment in severe acute pancreatitis-associated cardiac injury.