Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adverse reactions to the drugs employed in the National Cooperative Crohn's Disease Study were sought prospectively at each patient visit and by retrospective review of all patient charts. Prednisone caused evident side effects in over 50% of patients on high-dose suppressive therapy and in approximately one-third of patients on prophylactic dose. Thirty-two percent of patients on high-dose, and 26% on prophylactic-dose prednisone required dose reduction or withdrawal because of side effects. Comparable figures for sulfasalazine were 14% and 12%, and for azathioprine 32% and 20%. The incidence of nausea, vomiting, or anorexia among patients taking sulfasalazine was 46% and 34%, on high and low dose respectively; however, this incidence was no different than that observed among patients taking placebo. These symptoms occasioned withdrawal from the study of only 4% and 3% of patients on high and low doses of sulfasalazine, respectively. Azathioprine produced leukopenia at a dose of 2.5 mg/kg body weight in 15% of patients and the mean white cell count, lymphocyte count, granulocyte count, and hematocrit all fell significantly in patients on this dose. Pancreatitis occurred in 5% of patients taking azathioprine but in no other patients. Sulfasalazine proved to be the safest effective suppressive drug for Crohn's disease. Prednisone toxicity, though substantial, is acceptable in view of its demonstrated suppressive efficacy. Azathioprine was approximately as toxic as prednisone but no more effective than placebo in suppressing active disease. None of the drugs was effective prophylactically, and all showed appreciable long-term toxicity.
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PMID:National Cooperative Crohn's Disease Study: adverse reactions to study drugs. 3 77

Myelosuppression is associated with human immunodeficiency virus (HIV) infection and may also be produced by agents used for the treatment of the disease or the treatment of its complications. Didanosine (ddl; 2',3'-dideoxyinosine) is a newer purine nucleoside that has recently become available for therapy for HIV infection. The effects of didanosine on peripheral blood counts have been retrospectively evaluated in the first 170 patients treated with this new agent in four phase I trials. Patients treated with didanosine showed statistically significant improvements in hemoglobin levels, white cell counts, and granulocyte and platelet numbers as compared with baseline values. These changes were seen with or without prior therapy with zidovudine, were somewhat more pronounced at higher doses of didanosine, and persisted for up to 1 year. Reported adverse events included peripheral neuropathy, diarrhea, and most notably, pancreatitis. It is concluded that, while some toxic side effects occur, didanosine therapy in HIV infection is associated with an amelioration of HIV-induced myelosuppression.
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PMID:Effects of therapy with didanosine on hematologic parameters in patients with advanced human immunodeficiency virus disease. 146 12

The theory of granulocyte embolization in the retinal arterioles in acute pancreatitis cannot account for several aspects of the ophthalmic complication. Therefore we studied retinal circulation by fluorescein angiography, light and transmission electron microscopy following the first six hours of acute experimental necrotizing pancreatitis. The studied period was characterized by high serum lipase and amylase concentrations, hypocalcemia, necrosis of the pancreatic tissue and preceded the development of hypovolemic shock. Ophthalmoscopy and fluorescein angiography revealed no pathologic alterations and no granulocyte aggregation was found. Our results suggest that granulocyte aggregation induced by pancreatic enzymes is not the reason for the ophthalmic circulatory disturbances in acute pancreatitis.
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PMID:Is retinopathy in pancreatitis caused by leukocyte emboli? 148 94

Complexes of granulocyte elastase and alpha 1-antitrypsin are markers for granulocyte activation. In 75 patients with acute pancreatitis these complexes were immunologically determined daily in plasma during the first week of hospitalization. Patients were classified into three groups: mild pancreatitis (I, less than or equal to 1 complication, N = 34), severe pancreatitis (II, greater than or equal to 2 complications, N = 29), lethal outcome (III, N = 12). Initially, granulocyte elastase (mean +/- SEM) was lower in group I (348 +/- 39 micrograms/liter) as compared to groups II (897 +/- 183 micrograms/l) and III (799 +/- 244 micrograms/liter), P less than 0.001 for I vs II + III. Initial elastase concentrations greater than 400 micrograms/liter were consistent with a severe or fatal course of the disease but did not distinguish between severe and lethal pancreatitis. In patients with mild or severe disease, mean elastase concentrations decreased continuously during the following days (197 +/- 15 micrograms/liter in mild cases, 325 +/- 30 micrograms/liter in severe cases at day 7). In patients with lethal disease, however, mean elastase concentrations even increased at day 2 and remained higher than 700 micrograms/liter during the observation period. At days 1 and 2 the predictive value for severe or lethal disease of raised (greater than 400 micrograms/liter) elastase concentrations [positive predictive value (PPV) 82%, negative predictive value (NPV) 81%] was better than that of elevated (greater than 100 mg/liter) C-reactive protein (PPV 73%, NPV 73%), elevated (greater than 4.0 g/liter) alpha 1-antitrypsin (PPV 59%, NPV 50%), or decreased (less than 1.5 g/liter) alpha 2-macroglobulin (PPV 82%, NPV 67%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Granulocyte elastase in assessment of severity of acute pancreatitis. Comparison with acute-phase proteins C-reactive protein, alpha 1-antitrypsin, and protease inhibitor alpha 2-macroglobulin. 168 26

We examined the effects of acute hemorrhagic pancreatitis in the sheep lung lymph fistula preparation. Pulmonary lymph flow and transvascular protein clearance increased after pancreatitis was induced by injection of sodium taurocholate and trypsin into the pancreas in control sheep. However, neither parameter was altered in sheep pretreated with the protease inhibitor, Trasylol (initial bolus injection, 5,000 KIU/kg followed by 5,000 KIU/kg for 4 h). In addition, in the control animals, both peripheral granulocyte count and the arterial fibrinogen concentration decreased, but these changes did not occur after pancreatitis in the Trasylol-pretreated animals, suggesting that the generation of proteases is responsible for granulocyte sequestration and intravascular coagulation after pancreatitis. The platelet count decreased comparably in both groups, indicating a lack of involvement of platelets in lung vascular injury. Therefore, generation of proteases is an important factor in the mediation of increased lung vascular permeability after acute hemorrhagic pancreatitis.
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PMID:Pancreatitis-induced increase in lung vascular permeability. Protective effect of Trasylol. 620 Oct 93

Out of 26 patients with acute pancreatitis, 8 had several signs of bacterial infection such as high nitroblue tetrazolium (NBT) reduction of granulocytes, fever, elevated ESR and leukocytosis with granulocytosis. 2 patients had a high NBT-value without all other clinical signs of infection and 6 had such signs without a high NBT-value. --An NBT-value lower than normal was found in 6 patients, 3 of whom also had other signs of infection. The level of serum lipids, determined in only 3 of the 6, demonstrated concomitant hypertriglyceridemia. Hyperlipidemia is known to decrease granulocyte activity and might have prevented a stimulation to increased NBT-reduction otherwise brought about by bacterial infection. Further, 3 of the 6 patients with low NBT-reductions suffered from a very severe type of pancreatitis and two of them developed pneumonia. --Bacterial infection may thus contribute to a severe clinical course of pancreatitis, especially in patients with hypertriglyceridemia in whom the granulocyte function is depressed.
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PMID:Granulocyte-function in pancreatitis. Nitroblue tetrazolium-test related to clinical signs of bacterial infection and to hypertriglyceridemia. 693 88

A 32-year-old black woman with pancreatitis developed visual loss in both eyes. On ophthalmoscopic examination she had extensive ischaemic infarcts at the posterior poles of both eyes, a clinical picture which has been reported previously in patients with pancreatitis and noted to be similar to Purtscher's retinopathy. On histopathological examination of the eyes after death there were arteriolar occlusions in both the choroid and retina and inner ischaemic infarctions with inner retinal oedema. Owing to the 23-day interval from arteriolar occlusion until death the exact nature of the original occlusion could not be determined. However, either fat emboli or activated complement C5-induced granulocyte embolus formation are possible causes.
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PMID:A clinicopathological case report of retinopathy of pancreatitis. 706 74

We examined the role of granulocytes in the development of increased pulmonary vascular permeability during acute pancreatitis in acute sheep lung lymph preparation. One group of animals was depleted of 95% of circulating granulocytes by injection of hydroxyurea. In this group and in a second group of control animals, acute hemorrhagic pancreatitis was produced by injection of trypsin and sodium taurocholate acid into the pancreas. Pulmonary lymph flow and transvascular protein clearance increased without changes in pulmonary vascular pressures, indicating that acute pancreatitis h ad produced a pulmonary vascular injury. These changes occurred with a decrease in circulating granulocytes. Prior granulocyte depletion prevented the increases in lymph flow and protein clearance produced by pancreatitis, whereas the changes in platelet count, fibrinogen, and peritoneal fluid amylase concentrations were similar in both groups. These findings indicate that circulating granulocytes are necessary for the development of pulmonary vascular injury after acute pancreatitis.
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PMID:Prevention of increased pulmonary vascular permeability after pancreatitis by granulocyte depletion in sheep. 714 57

The role of the inflammatory response in acute pancreatitis and its relation with the clinical course was examined. This study examined if the serial measurement of polymorphonuclear granulocyte (PMN) elastase/A1PI complex, phospholipase A catalytic activity, C reactive protein, and other acute phase proteins, and the protease inhibitor alpha 2-macroglobulin, provides meaningful information for prognosis. Eighty non-consecutive patients with acute pancreatitis, classified according to their clinical outcome into mild (n = 40) and severe pancreatitis (n = 40), were followed up daily. Between 48 hours, median values of PMN-elastase, C reactive protein--and most of the acute phase proteins--and phospholipase A activity, were significantly higher in the severe pancreatitis group. PMN elastase shows a dynamic course and it reaches an early peak value at days 1-2, followed by C reactive protein (days 2-4) phospholipase A (day 3), and a negative peak for alpha 2-macroglobulin (days 4-5). PMN elastase (day 1) and C reactive protein (day 2) were selected by discriminant analysis as the most useful variables studied to allow the early accurate prediction of severity (sensitivity 100%, specificity 95%). Little or no predictive additional value was found for all other variables studied. These results strongly suggest a close relation between inflammatory parameters and clinical course in acute pancreatitis, and discriminant analysis of these variables provides a useful method to classify severity.
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PMID:Inflammatory response in the early prediction of severity in human acute pancreatitis. 751 79

Isolation of the proteinases inhibitors, available for medicinal purposes, was described, where the inhibitor of the Kunitz type was obtained from bovine pancreas and the inhibitor of the Bowman-Birk type from soybeans. Screening of the immobilization procedures was carried out, which enabled the authors to produce the polymeric conjugates of the proteinase inhibitors exhibiting the maximal rate of activity against pancreatic proteinases and granulocyte elastases. Pharmacokinetics of the proteinase inhibitors obtained was studied. High molecular derivatives of the inhibitors from the bovine pancreas circulated in rat blood in larger quantities and longer, their total clearance was 5 times than native inhibitor preparations. The preparations containing these inhibitors from bovine pancreas exhibited a high therapeutic efficiency in treatment of rats with hemorrhagic pancreatitis and acute liver failure in rabbits.
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PMID:[Natural proteinase inhibitors as a basis for creating new drugs]. 752 47


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