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Pancreatic microcirculation in acute pancreatitis

M Sunamura1, J Yamauchi, K Shibuya

  • 1First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-77, Japan.

Journal of Hepato-Biliary-Pancreatic Surgery
|July 31, 1998
PubMed
Summary

Impaired pancreatic microcirculation is key in acute pancreatitis progression. This study visualizes and quantifies changes in blood vessels and leukocyte behavior, identifying bradykinin and oxygen radicals

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Area of Science:

  • Gastroenterology and Hepatology
  • Vascular Biology
  • Pathophysiology

Background:

  • The pancreas's microvascular morphology and lobular microstructure are crucial for its function.
  • Acute pancreatitis significantly impacts pancreatic microcirculation, potentially driving disease progression.

Purpose of the Study:

  • To review pancreatic microvascular morphology and lobular microstructure.
  • To investigate and quantify microcirculatory changes in acute pancreatitis.
  • To elucidate the mechanisms underlying microcirculatory impairment during pancreatitis.

Main Methods:

  • Review of existing literature on pancreatic microvasculature.
  • In vivo microscopy for direct visualization of pancreatic microcirculation.
  • Off-line computer analysis for quantifying microvascular permeability and leukocyte behavior.

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Main Results:

  • Impaired pancreatic microcirculation, characterized by increased vascular permeability and reduced blood flow, is observed early in acute pancreatitis.
  • Bradykinin and oxygen radicals contribute to increased vascular permeability in caerulein-induced pancreatitis.
  • Leukocyte-endothelial cell interactions, mediated by CD11b/18 integrin, are critical for leukocyte infiltration during pancreatitis exacerbation.

Conclusions:

  • Early microcirculatory dysfunction is a significant factor in acute pancreatitis.
  • Understanding these microvascular changes provides insights into pancreatitis pathogenesis.
  • Targeting leukocyte-endothelial cell interactions may offer therapeutic strategies.