Protein C activation during the initial phase of experimental acute pancreatitis in the rabbit

Background: Disturbances of coagulation and fibrinolysis are well-known sys temic effects of acute necrotising pancreatitis (ANP). The purpose of this experimental study was to evaluate the initial events in the haemostatic ac tivation during ANP in an animal model with relevance to the human situatio n. Methods: ANP was introduced in 7 rabbits by infusion of chenodeoxycholic acid in the pancreatic duct. Seven rabbits served as sham-operated control s. Serial measurements of coagulation variables (prothrombin time, activate d partial thromboplastin time, FVII activity, fibrinogen, tissue factor act ivity), anticoagulant proteins (protein C, antithrombin) and fibrinolytic f actors (tissue plasminogen activator, plasminogen activator inhibitor-1) we re performed for 5 h. Results: ANP was confirmed by elevated serum amylase, development of ascites, and histological changes of the pancreas. A modera te activation of the coagulation system was found in both study groups. A s ignificant decrease in protein C concentration from 1 h after the induction of ANP was found, whereas the response of antithrombin and the inhibition of the fibrinolytic system were similar in the 2 study groups. Microthrombo sis of the lungs or kidneys was found in 2 rabbits with ANP. Conclusion: An immediate activation of protein C is a specific characteristic of the haem ostatic activation in ANP in rabbits. This activation has not been describe d previously and the possible therapeutic implications ought to be studied. Copyright (C) 1999 S. Karger AG, Basel.