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Invited Response |

Decreased Inflammation and Improved Survival With Recombinant Human Activated Protein C Treatment in Experimental Acute Pancreatitis—Invited Response

Guido Alsfasser, MD; Andrew L. Warshaw, MD; Carlos Fernández-del Castillo, MD
Arch Surg. 2006;141(7):677. doi:10.1001/archsurg.141.7.677.
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In the 15 years since we first described our pancreatitis model,1 we have performed dozens of experimental studies related to its pathogenesis and treatment and have never before encountered an intervention with such a dramatic effect in the early phases of the disease. It is not only that we found a significantly improved 24-hour survival, but also that surviving rats (almost the entire treatment group) appeared remarkably healthier. We were surprised when evaluation of the pancreas showed no difference between controls and treated rats, and from there we assume the improvement related to less lung injury, which is the earliest and most common form of organ failure associated with pancreatitis. This hypothesis is backed by the almost complete normalization of myeloperoxidase concentration in lungs. Myeloperoxidase has been found by us and other investigators2,3 to correlate very closely with both leukocyte infiltration and histologic lung injury.

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