Acute pancreatitis,treatment,agmatine,cerulein,rat

Background/aim: Acute pancreatitis is a clinical picture with a wide range of symptoms from mild inflammation to multiorgan failure and death. The aim of this study is to investigate the effects of Adalimumab (ADA) on inflammation and apoptosis in a cerulein-induced acute pancreatitis model in rats. Material and methods: Experimental cerulein-induced acute pancreatitis model was created by applying 4 intraperitoneal cerulein injections at 1-h intervals. A total of 40 rats, 8 in each group, were randomly distributed into five groups. In the groups that ADA treatment was given, two different doses of ADA were administered 5 mg/kg and 20 mg/kg as low and high doses, respectively. The rats were sacrificed 12 h after the last intraperitoneal administration of ADA. Blood samples were obtained from each rat for amylase, IL-6, and IL-1ß measurements. Hematoxylin and Eosin (H&E) stains were used to undertake the histopathological analysis of the pancreas. The terminal deoxynucleotidyl transferase-mediated nick-end-labeling (TUNEL) method was used to evaluate apoptosis. Results: Plasma amylase, IL-6, and IL-1ß levels were significantly elevated in acute pancreatitis groups (p < 0.05). It was determined that both low (5 mg/kg) and high doses (20 mg/kg) of ADA ameliorated the parameters (plasma amylase, IL-6, and IL-1ß) (p < 0.05). Although significant improvements were detected in the Schoenberg scoring system and the apoptotic index from the TUNEL method after highdose ADA treatment, no significant amelioration was observed in the histopathological examinations in the low-dose ADA group. Conclusions: It has been determined that the administration of high-dose ADA effectively alleviated the symptoms of acute pancreatitis and reduced the level of apoptosis. In line with the findings of our study, we have predicted that high-dose (20 mg/kg) ADA can be used as an effective and safe drug in the treatment of patients with acute pancreatitis.

Background: The aim of the study was to evaluate whether a new and successful treatment opportunity can be provided in acute pancreatitis and may prevent symptomatic treatments and show its effect through etiopathogenesis. Therefore, we want to investigate the efficacy of golimumab in an experimental rat model of cerulein-induced acute pancreatitis. Methods: A total of 35 rats, including 7 rats in each group, were distributed into 5 groups (sham, acute pancreatitis, placebo, acute pancreatitis+golimumab 5 mg/kg, and acute pancreatitis+golimumab 10 mg/kg). An experimental cerulein-induced acute pancreatitis model was accomplished by intraperitoneal cerulein injections. After sacrification, rat blood samples were collected for amylase, IL-6, and IL-1beta measurements. Histopathological analysis of the pancreas was performed with Tunel and hematoxylin & eosin staining. Results: Amylase, IL-6, and IL-1beta levels were found to be increased in the acute pancreatitis group. IL-1beta, amylase, IL-6 levels, and pancreatic inflammation were all significantly decreased in golimumab groups (P < .01). Moreover, in both golimumab groups, golimumab treatment significantly reduced apoptosis in pancreatic tissues (P < .05). Golimumab treatment was found to significantly reduce edema formation, inflammation, vacuolization, and fat necrosis of pancreatic tissues (P < .05). Conclusion: Firstly in the literature, we investigated the efficacy of golimumab in the experimental acute pancreatitis model. In the light of our findings, it could be suggested that golimumab may be an effective and safe therapeutic option in the treatment of patients with acute pancreatitis Cite this article as: Kaplan M, Tanoğlu A, Çakır Güney B, et al. Golimumab ameliorates pancreatic inflammatory response in the cerulein-induced acute pancreatitis in rats. Turk J Gastroenterol. 2022;33(11):918-924.

Acute pancreatitis is an acute inflammatory event involving the pancreas and causes significant mortality and morbidity. The most common causes are gastrointestinal stones and alcohol abuse, but well-known drugs used in daily practice can also cause acute pancreatitis. In this rare case report, we aimed to present a case of levetiracetam-associated acute pancreatitis.

Background and Objectives: The relationship between psychiatric disorders and systemic inflammation remains incompletely understood. Increasing evidence suggests that inflammatory processes may play a role in the biological mechanisms underlying suicidal behavior. This study aimed to investigate the association between classical inflammatory markers and hemogram-derived inflammatory indices in patients who attempted suicide by oral drug overdose. Materials and Methods: This retrospective observational comparative study included 343 patients hospitalized following a suicide attempt by oral medication overdose and 421 age- and sex-matched healthy individuals. Serum C-reactive protein (CRP), albumin levels, complete blood count parameters, and derived inflammatory indices, including the CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), systemic immune–inflammation index (SIII), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), were analyzed. Results: Patients with suicide attempts had significantly higher CRP, leukocyte, neutrophil, and monocyte levels compared to the comparison group. CAR, NLR, SIII, and MLR values were also significantly elevated, whereas PLR did not differ between groups. ROC analysis demonstrated that CAR showed the highest discriminative ability for suicide attempt, with high sensitivity and specificity. Conclusions: Hemogram-derived inflammatory indices, particularly CAR, were significantly associated with suicide attempts. These easily accessible and low-cost biomarkers may provide additional biological insight into suicide risk assessment. Further prospective studies are needed to confirm these findings.

Background and Objectives: Fingolimod, a sphingosine-1-phosphate receptor modulator, is an effective disease-modifying therapy for relapsing forms of multiple sclerosis (MS). Although lymphopenia is a well-recognized pharmacological effect, its clinical significance remains uncertain. This study evaluated the frequency and severity of fingolimod-associated lymphopenia, longitudinal hematological changes and their relationship with clinical outcomes in a real-world MS cohort. Materials and Methods: This retrospective observational study included 143 adults with MS who initiated fingolimod treatment between May 2019 and October 2020. Demographic, clinical and laboratory data were collected at baseline and at 3- and 6-month follow-up visits. Lymphopenia was graded according to the Common Terminology Criteria for Adverse Events version 4.0. Laboratory parameters and infection outcomes were compared according to lymphopenia severity. Logistic regression analysis was performed to identify factors associated with Grade 4 lymphopenia at 6 months. Results: At 6 months, lymphopenia was present in 124 patients (86.7%), including Grade 4 lymphopenia in 15 (10.5%). Leukocyte, neutrophil and lymphocyte counts decreased, whereas ALT, AST, GGT, NLR and SII increased significantly during treatment (all p < 0.001). Infection frequency did not differ among lymphopenia severity groups (p = 0.530). No statistically significant association was detected between Grade 3–4 lymphopenia and infection risk (OR, 1.41; 95% CI, 0.42–4.71; p = 0.545). Lower baseline lymphocyte count was independently associated with Grade 4 lymphopenia (adjusted OR 0.078, 95% CI 0.018–0.325; p < 0.001). Conclusions: Fingolimod-associated lymphopenia was common, with Grade 4 lymphopenia affecting approximately one-tenth of patients. No statistically significant association between lymphopenia severity and infection was detected; however, the small number of Grade 4 cases, low event rate and wide confidence interval limited the statistical power to exclude clinically meaningful differences. These findings should therefore be interpreted cautiously and do not establish the absence of infection risk associated with severe lymphopenia. Regular hematological monitoring and individualized clinical decision-making remain essential, particularly in patients with lower baseline lymphocyte counts.