Role of enteral ebselen and ethylhydroxyethyl cellulose in pancreatitis-associated multiple-organ dysfunction in humans

摘要

Objective. Acute pancreatitis (AP) remains a severe disease responsible for the development of multiple organ dysfunction, and is associated with high mortality and morbidity. Early enteral nutrition has been suggested to have therapeutic potential for improving the outcome of AP patients. The aim of this study was to investigate whether supplementation of enteral nutrition with ebselen and ethylhydroxyethyl cellulose (EHEC) can attenuate the acute-phase responses and the severity of organ dysfunction in AP patients with either single- or multiple-organ dysfunction. Material and methods. AP patients with single-organ dysfunction (acute lung dysfunction) were treated with either vehicle (n =43) or the combination of ebselen and EHEC (n =48). AP patients with multiple-organ dysfunction (more than two organs) were treated with either vehicle (n=52) or the combination of ebselen and EHEC (n = 55). Results. The combination of ebselen and EHEC significantly reduced the occurrence of infection (as indicated by a lower frequency of fever and a shorter duration of antibiotic use), improved gastrointestinal function (shorter period of bowel opening) and altered inflammatory responses by down-regulation of circulating interleukin-6, monocyte chemoattractant protein-1 and interleukin-1 receptor in AP patients with single- or multiple-organ dysfunction, and improved the outcome of AP patients with multiple-organ dysfunction by reducing hospital stay and mortality. Conclusion. The combination of ebselen and EHEC is a new therapy with potential clinical benefit for the treatment of severe AP.