Fasting exacerbates acute pancreatitis by occlusion of the common bile duct in rats

We examined the effects of fasting and non-fasting on gallstone-related acu te pancreatitis by the occlusion of the common bile duct (OCD). We prepared a rat OCD-induced pancreatitis model under both fasting and non-fasting co nditions, and we measured amylase activity in ascites as well as production of inflammatory cytokines and chemokines. We also examined the pathology o f the pancreas, myeloperoxidase (MPO) activity in some tissues and mortalit y rates. In the fasted OCD group, ascites containing a large amount of amyl ase, interleukin 1 beta (IL-1 beta), interleukin 6 (IL-6), and cytokine-ind uced neutrophil chemoattractant-1 (CINC-1) as well as marked hemorrhage and necrosis of the pancreatic acinar cells were observed. Pulmonary MPO activ ity increased 3.4-fold compared to the control group. In the non-fasted OCD group, there was no development of ascites. Slight necrosis of acinar cell s and slight increases in pulmonary MPO activity were observed. In addition , in the fasted OCD group, the cumulative mortality rate was 50% 6 days aft er ligation. However, in the non-fasted OCD group, none of the animals died . These results suggest that gallstone-related severe pancreatitis depends on fasting-related structural and/or functional changes in the pancreas. Mo reover, increased production of inflammatory cytokines and chemokines in as cites under fasting condition may be involved in multiple organ failure res ulting from severe acute pancreatitis.