COMBINED TREATMENT WITH C1 ESTERASE INHIBITOR AND ANTITHROMBIN-III IMPROVES SURVIVAL IN SEVERE ACUTE EXPERIMENTAL PANCREATITIS

Background-Patients with severe acute pancreatitis die of complication s closely related to the systemic activation of protease cascades. Aim -To examine the effects of human C1 esterase inhibitor (C1 INH) and an tithrombin III (AT III) on two experimental models of acute pancreatit is. Methods-Oedematous pancreatitis was induced by continuous intraven ous infusion of caerulein and haemorrhagic pancreatitis by retrograde injection of sodium taurocholate into the biliopancreatic duct. C1 INH and AT III were given intravenously, either before or after the induc tion of pancreatitis. Treatment with C1 INH and AT III had no benefici al effect on oedematous pancreatitis. On the other hand, combined C1 I NH and AT III therapy improved the survival in haemorrhagic pancreatit is compared with treatment with human serum albumin. This reduction in mortality was found regardless of whether the treatment was given pro phylactically or therapeutically. Conclusions-treatment with C1 INH an d AT III represents a promising therapeutic concept for patients with severe haemorrhagic pancreatitis.