March 17, 2007
Filed under digestive
CM NEWS – A common Chinese herb dan shen (丹参, Salvia miltiorrhiza) may help patients with severe acute pancreatitis, in which the pancreas is dying from the acute inflammation, by controlling the serum levels of cytokines that play a key role in advancing inflammation to mulitple organs.
In the present study by researchers at the Department of Gastroenterology of Yingtan 184 Hospital in Jiangxi, China, 36 patients with severe acute pancreatitis were randomly divided into dan shen-treated group and non-danshen-treated group with eighteen patients in each group. 14 age-matched healthy volunteers were assigned to control group.
What is acute pancreatitis? Pancreatitis is a condition associated with development of acute and sudden inflammation of the pancreas. Experimental data show that during an attack of pancreatitis, pancreatic enzymes are released in the abdomen and cause inflammation by the damage from digestion of normal body structures, especially fat in the abdomen. In about 85% of patients, acute pancreatitis is a mild disease and is usually associated with a rapid recovery within a few days of onset of the illness.
Gallstones and excessive alcohol usage are the most common causes for injury to the pancreas and account for more than 85% of all patients that develop pancreatitis. Many medications, and conditions such as hyperlipidemia (high levels of fat in the blood), and hypercalcemia (high levels of calcium in the blood) may also cause pancreatitis.
In about 15-20% of patients with acute pancreatitis, severe damage to the pancreas may lead to a life threatening illness that is often associated with prolong hospitalization, multiple surgical procedures, and death in some patients. Severe acute pancreatitis usually develops when parts of the pancreas become necrotic (dead) from the acute inflammation. Many of the complications seen in severe acute pancreatitis are associated with the presence of this dead pancreatic tissue in the abdomen.
Severe acute pancreatitis is a serious and life threatening disease and require intensive and aggressive management of multiple organ failure and severe infective complications that develop in these patients. Many of the complications seen in severe acute pancreatitis are associated with the presence of the dead pancreatic tissue in the abdomen.
The researchers tested patients’ serum levels of three cytokines: interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-alpha (TNF-alpha) within 24 hours of admission and 7 days after admission.
What are cytokines? Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. These chemical signals are similar to hormones and neurotransmitters and are used to allow one cell to communicate with another. While hormones are released from specific organs into the blood and neurotransmitters are released by nerves, cytokines are released by many types of cells. They are particularly important in both innate and adaptive immune responses. Due to their central role in the immune system, cytokines are involved in a variety of immunological, inflammatory and infectious diseases.
Some patients with severe acute pancreatitis progress from a limited local inflammation to a potentially dangerous systemic inflammatory response. According to literature, the probable cause is high levels of circulating proinflammatory cytokines, which induce activated white cells to escape into the tissue parenchyma of lungs, kidneys, liver, haemopoetic and vascular system. Cytokine release from tissue macrophages are thought to be the trigger for the cytokine cascade.
This event leads to the migration of blood monocytes and neutrophils to the site of injury and these cells are then capable of secreting a large variety of damaging inflammatory mediators. The degree to which these mediators escape into the circulation contributes to the induction of the systemic inflammatory response syndrome (SIRS), acute phase response, and multiple organ failure. Organ dysfunction occurs in one in four patients with acute pancreatitis and 60% of patients who die in the first week of the disease die from pulmonary damage resulting from adult respiratory distress syndrome.
Controlling the levels of pro-inflammatory cytokines thus becomes a crucial way to prevent inflammation to advance to multiple organs.
The results of the present study show that serum levels of the three cytokines were significantly decreased in both dan shen-treated group and non-dan shen-treated group after 7-day treatment. The declining of the serum levels of the three cytokines in danshen-treated group was more obvious than that in non-dan shen-treated group.
The researchers thus conclude that by reducing serum levels of the three cytokines, dan shen can treat patients with severe acute pancreatitis.