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目的观察肿瘤坏死因子-α(TNF-α)在重症急性胰腺炎(SAP)肾上腺细胞凋亡中的作用。方法采用随机数字表法将40只雄性Wistar大鼠随机分为假手术组(SO组)和SAP组,SAP组又再分为3、6、12及24 h4个亚组,每组8只大鼠。采用5%牛黄胆酸钠(0.1 m L/100 g)逆行胆胰管注射法建立SAP大鼠模型,测定各组大鼠血清淀粉酶及脂肪酶水平,观察胰腺和肾上腺组织的病理学改变,并进行评分;用TUNEL法检测肾上腺细胞凋亡情况,并比较各组大鼠的凋亡指数;采用Western blot法检测肾上腺组织中TNF-α及Caspase-3蛋白的表达。结果造模术后各时间点SAP组大鼠血清淀粉酶和脂肪酶水平以及胰腺组织和肾上腺组织的病理学评分均较SO组显著升高(P<0.05);随病程延长,SAP组大鼠肾上腺细胞凋亡指数也进行性升高,并均高于SO组(P<0.05);SAP组大鼠肾上腺组织中TNF-α和Caspase-3蛋白的相对表达量也逐渐增高,24 h时略有下降,但均高于SO组(P<0.05)。结论 TNF-α可能参与了SAP时的肾上腺损伤,可能通过激活Caspase-3在SAP肾上腺细胞凋亡中发挥重要作用。
Objective To investigate the role of tumor necrosis factor-α (TNF-α) in the apoptosis of adrenal cells in patients with severe acute pancreatitis (SAP). Methods Forty male Wistar rats were randomly divided into sham operation group (SO group) and SAP group by random number table method. The SAP group was subdivided into 4, 4, 6, 12 and 24 h subgroups, mouse. The rat model of SAP was established by retrograde cholangiopancreatic injection of 5% sodium taurocholate (0.1 m L / 100 g), the levels of serum amylase and lipase were measured, the pathological changes of pancreas and adrenal were observed, The apoptosis of adrenal cells was detected by TUNEL method. The apoptosis index of rats in each group was compared. The expression of TNF-α and Caspase-3 protein in adrenal tissues was detected by Western blot. Results The levels of serum amylase and lipase and the pathological scores of pancreatic tissue and adrenal tissue in SAP group were significantly higher than those in SO group (P <0.05) at all time points after SAP. Compared with SAP group, The apoptotic index of adrenal cells also increased progressively, and both were higher than that of SO group (P <0.05). The relative expression of TNF-α and Caspase-3 protein in adrenal tissue of SAP group also increased gradually, Decreased, but both were higher than SO group (P <0.05). Conclusion TNF-α may be involved in adrenal injury in SAP and may play an important role in the apoptosis of SAP adrenal cells by activating Caspase-3.