Role of ET and ANF in the pathogenesis of early acute pancreatitis

Objective: To investigate the role played by endothelin (ET) and atrial natriuretic factor (ANF) in the development of acute pancreatitis. Methods: Plasma ET and ANF levels were measured with RIA in 35 patients with mild acute pancreatitis (MAP) and 17 patients with severe acute pancreatitis (SAP) within 24-48h after onset of disease as well as in 30 controls. Patients with Imrie score>3, APACHE II score ≥8 were classified as severe. Results: Plasma ET levels in patients with SAP (59.20 + 10. 69pg/ml) were significantly higher than those in controls (P<0.001). However, the plasma Et levels in patients with Map (34.20 ± 9.44 pg/ml) were significantly lower than those in controls (46.81 ± 10.32 pg/ml, P<0.001). Plasma An levels in patients with Sap and patients with Map were (155.76 ± 34.24 pg/ml) and (188.59 ± 58.15pg/ml) respectively; both were not much different from the levels in controls (165.51 ± 57.67 pg/ml), P>0.05. Conclusion: Increased Et levels in Sap patients might aggravate the ischemia and impairment of microcirculation, leading to endogenous injury of pancreatic tissue. Administration of ET/ET receptor antagonists early in the course might be therapeutically helpful. Effect of ANF seemed to be negligible. (authors)