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Experimental Study of Interstitial Injection of Trypsin and Trypsinogen into the Pancreas

Experimental Study of Interstitial Injection of Trypsin and Trypsinogen into the Pancreas Abstract Many of the factors in the pathogenesis and experimental production of acute pancreatitis are conflicting and controversial. It is generally conceded that interstitially extravasated, active trypsin in the pancreas plays a dominant role.1,2 Evidence further indicates that if, in addition, ductal obstruction or ischemia supervenes, necrotic or hemorrhagic pancreatitis is likely to ensue.1-4 The pivotal issues seem to be (1) the mechanism by which trypsin or trypsinogen is extravasated, (2) whether trypsinogen itself can cause pancreatitis, and (3) the manner in which trypsinogen is activated. The majority of investigators have utilized ductal perfusion of bile or pancreatic juice.1,3 Stein and co-workers have produced hemorrhagic pancreatitis by injection of trypsin into the dog's pancreaticoduodenal artery and ligation of the pancreatic ducts. Hosie and Ziffren5 have implicated collagenase, normally contained in pancreatic juice, as the initiator of pancreatitis. Since much of the experimental evidence indicating active trypsin as References 1. Stein, A. A.; Powers, S. R., Jr., and Browne, H. H.: Experimental Hemorrhagic Pancreatitis: New Concepts of Pathogenesis , Ann. Surg. 143:508 ( (April) ) 1956.Crossref 2. Powers, S. R., Jr.; Browne, H. H., and Stein, A. A.: The Pathogenesis of Acute and Chronic Pancreatitis , Ann. Surg. 142:690 ( (Oct.) ) 1955.Crossref 3. Nemir, P., Jr., and Drabkin, D. L.: Pathogenesis of Acute Necrotizing Hemorrhagic Pancreatitis: An Experimental Study , Surgery 40:171 ( (July) ) 1956. 4. Block, M. A.; Wakim, K. G., and Baggenstoss, A. H.: Experimental Studies Concerning Factors in the Pathogenesis of Acute Pancreatitis , Surg. Gynec. & Obst. 99:83 ( (July) ) 1954. 5. Hosie, R. F., and Ziffren, S. E.: Relationship of Collagenase to Pancreatitis , Surgery 40:185 ( (July) ) 1956. 6. Waite, J. H.: Recurring Pancreatitis in Dogs , S. Forum , pp. 516-521, 1952. 7. Kunitz, M., and Northrop, J. H.: Isolation from Beef Pancreas of Crystalline Trypsinogen, Trypsin, a Trypsin Inhibitor, and Inhibitor-Trypsin Compound , J. Gen. Physiol. 19:991 ( (July) ) 1936. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Experimental Study of Interstitial Injection of Trypsin and Trypsinogen into the Pancreas

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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1958.01290030116013
Publisher site
See Article on Publisher Site

Abstract

Abstract Many of the factors in the pathogenesis and experimental production of acute pancreatitis are conflicting and controversial. It is generally conceded that interstitially extravasated, active trypsin in the pancreas plays a dominant role.1,2 Evidence further indicates that if, in addition, ductal obstruction or ischemia supervenes, necrotic or hemorrhagic pancreatitis is likely to ensue.1-4 The pivotal issues seem to be (1) the mechanism by which trypsin or trypsinogen is extravasated, (2) whether trypsinogen itself can cause pancreatitis, and (3) the manner in which trypsinogen is activated. The majority of investigators have utilized ductal perfusion of bile or pancreatic juice.1,3 Stein and co-workers have produced hemorrhagic pancreatitis by injection of trypsin into the dog's pancreaticoduodenal artery and ligation of the pancreatic ducts. Hosie and Ziffren5 have implicated collagenase, normally contained in pancreatic juice, as the initiator of pancreatitis. Since much of the experimental evidence indicating active trypsin as References 1. Stein, A. A.; Powers, S. R., Jr., and Browne, H. H.: Experimental Hemorrhagic Pancreatitis: New Concepts of Pathogenesis , Ann. Surg. 143:508 ( (April) ) 1956.Crossref 2. Powers, S. R., Jr.; Browne, H. H., and Stein, A. A.: The Pathogenesis of Acute and Chronic Pancreatitis , Ann. Surg. 142:690 ( (Oct.) ) 1955.Crossref 3. Nemir, P., Jr., and Drabkin, D. L.: Pathogenesis of Acute Necrotizing Hemorrhagic Pancreatitis: An Experimental Study , Surgery 40:171 ( (July) ) 1956. 4. Block, M. A.; Wakim, K. G., and Baggenstoss, A. H.: Experimental Studies Concerning Factors in the Pathogenesis of Acute Pancreatitis , Surg. Gynec. & Obst. 99:83 ( (July) ) 1954. 5. Hosie, R. F., and Ziffren, S. E.: Relationship of Collagenase to Pancreatitis , Surgery 40:185 ( (July) ) 1956. 6. Waite, J. H.: Recurring Pancreatitis in Dogs , S. Forum , pp. 516-521, 1952. 7. Kunitz, M., and Northrop, J. H.: Isolation from Beef Pancreas of Crystalline Trypsinogen, Trypsin, a Trypsin Inhibitor, and Inhibitor-Trypsin Compound , J. Gen. Physiol. 19:991 ( (July) ) 1936.

Journal

A.M.A. Archives Surgery – American Medical Association

Published: Sep 1, 1958

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