The prognostic role of the levels of ischemia-modified albumin in acute necrotizing pancreatitis in rats

Aim: acute pancreatitis is acute inflammatory disease that progresses involving thesurrounding tissues and organ systems. Pancreatic autodigestion and deterioration ofmicrocirculation are the most importasnt mechanisms in relation with acute pancreatitis.Increased vascular permeability, ischemia, inravascular coagulation, inadequate capillaryand venous drainage, especially capillary stase play role in microcirculation alterations innecrotisan pancretitis. Ischemic modified albumin (IMA), is recently developed indicatorto evaluate ischemic injury. The aim of this study is to investigate the correlation betweenIMA levels and, the severity of pancreatitis and histopathologic alterations.Materials and methods: In the study 59 male Sprague Dawley rats weighedbetween 300-350 gr were used and evaluated in 5 groups. Group 1 was the control group(n=7), group 2 was (n=10), group 3 was (n=10), group 4 was (n=16), group 5 was (n=16).After pancreatitis developed in group II 6 hours, in group III twelwe hours, in group IV 24hours, in group V 48 hours after the canulation, blood samples were taken for the serumamilase, alanin amino transferase (ALT), glucose, urea, calcium and ischemia modifiedalbümin (IMA) levels. Subsequently the pancreas of the rat was totally resected forhistopathologic evaluation.Results: There was increase of serum amylase, ALT and urea levels (p<0,005) anddecrease of glucose and calcium levels in all the groups that acute necrotisan pancreatitisdeveloped when compared to control group. In all the groups serum IMA levels werehighher than in the control group, howewer there was significantly difference betweencontrol group and group 4 and 5 (p<0,005). Mortality rates of group3, group4 and group 5were %20, %31 and %43,8 respectively. Histopathologic progression was parallelly relatedwith time.Conclusion: Serum IMA levels are found to be increased directly proportional withduration, severity of pancreatitis and histopathologic injury. This result is also in paralelwith mortality. Eventually IMA could be valuable biochemical determiner of prognosis ofacute necrotizing pancreatitis. Several clinical studies needed to support these results.