Therapy of acute necrotizing pancreatitis with antithrombin III

Background: In the current study the antiinflammatory influence of antithro mbin III (AT III) therapy on necrotizing pancreatitis was investigated. Methods: In male Wistar rats (250 g) necrotizing pancreatitis was induced b y intraductal injection of glucodesoxycholic acid and intravenous infusion of cerulein. In two experimental groups therapy with 125 IU per kg bodyweigth of AT III was compared with placebo (Ringer's solution). Survival and pancreatic micr ocirculation as quantified by intravital microscopy were measured. Results: 60 minutes after the beginning of AT III therapy in pancreatic cap illaries there was found a significant higher erythrocyte velocity and func tional capillary density. (p <0.01). Leukocyte-endothelium-interaction was also improved significantly in the AT III-group. Survival was not significa ntly different but there was a tendency for longer survival with AT III the rapy. Conclusion: This study was able to show that the therapy with AT III can im prove the microcirculatory disorder in necrotizing pancreatitis. Based on these data a therapeutic increase of plasma AT III-levels may infl uence the outcome of necrotizing pancreatitis.