THE EFFECT OF EPIDERMAL GROWTH-FACTOR ON THE SEPTIC COMPLICATIONS OF ACUTE-PANCREATITIS

Bacterial translocation (BT) from the gastrointestinal tract to mesent eric lymph nodes (MLN) and other extraintestinal organs is an importan t source of infection in acute pancreatitis (AP). Epidermal growth fac tor (EGF), a peptide hormone with trophic effects on gut mucosa, has d ecreased intestinal mucosal injury in septic rats and decreased burn-i nduced BT in mice. The purpose of this study is to examine whether EGF could affect BT in acute necrotizing pancreatitis. Forty-eight male S prague-Dawley rats (250-350 g) were studied. AP was induced in Group I and Group II by pressure injection of 3% taurocholate and trypsin int o the biliopancreatic duct (1 ml/kg of body weight). Group III and Gro up TV underwent laparotomy without induction of acute pancreatitis. Gr oup I rats received human recombinant EGF (100 mu g/kg, subcutaneously twice daily) and Group II rats received a similar volume of 0.1% bovi ne serum albumin as a placebo postoperatively. Group III and Group IV received EGF and placebo, respectively. At 48 hr postoperatively, bloo d was drawn for culture and amylase determinations. Jejunum and ileum were obtained to measure mucosal protein content, mucosal thickness, v illus height, and crypt depth. Specimens from MLN, spleen, liver, panc reas, and cecum were harvested for pathology and culture of gram posit ive (G+), gram negative (G-), and anaerobic bacteria. Ileal mucosal pr otein levels were increased significantly in Group I (1.96 +/- 0.14 mg /cm) compared to Group II (0.95 +/- 0.15 mg/cm intestinal segment) (P < 0.01). Jejunal and ileal mucosal thickness, villus height, and crypt depth in Group I were significantly increased when compared to Group II (P < 0.05). All 12 rats in Group II had BT to MLN compared to 58% ( 7 of 12 rats) in Group I (P < 0.05). Thirty-three percent (4 of 12 rat s) had BT to distant sites such as pancreas, spleen, liver, and/or blo od in Group I vs 83% (10 of 12 rats) in Group II (P < 0.05). EGF treat ment minimizes intestinal damage, decreases BT to MLN and bacterial sp read to distant sites, and may be beneficial in preventing septic comp lications in AP. (C) 1997 Academic Press.