Steroid administration and acute pancreatitis: studies with an isolated, perfused canine pancreas

Steroid administration has been suspected of causing acute pancreatitis for over 20 years. Clinical and experimental data, however, have failed to firmly establish the association or to uncover a pathogenic mechanism. Utilizing an isolated, ex vivo, perfused, canine pancreas preparation, the acute effects of large doses of steroids on the pancreas were evaluated. Using a dose of 200 mg of methylprednisolone, there were no significant differences between the control and steroid-treated preparations in terms of gross appearance, weight gain, serum amylase, or pancreatic secretion over a 4 hour perfusion period. When the dose of methylpredisolone was increased to 400 mg, again there were no significant differences in gross appearance, weight gain, or serum amylase during a 3 hour perfusion period. However, pancreatic secretion was initially depressed in the steroid-treated preparations. Following a maximal secretory stimulus (secretin), secretion markedly increased during the fourth hour of perfusion, but again was significantly less in the steroid-treated glands. Viscosity of pancreatic secretions was significantly increased in the steroid-treated glands. These studies suggest that steroids have a mild inhibitory effect on pancreatic secretion, which might be mediated through an increase in viscosity.