There is growing evidence that oxygen-derived free radicals (OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute pancreatitis. Many types of experimental ex vivo and in uitro pancreatitis can be inhibited by
superoxide
dismutase and catalse. Allopurinol also ameliorates the injury response. While these experiments strongly suggest the involvement of OFR's in some forms of experimental acute pancreatitis, their clinical significance is still unknown. Clinical
trials
with free radical scavengers or allopurinol are clearly needed to answer the question of free radical initiation of acute or chronic pancreatitis. The aim of this study was to know the role of OPR's on the ERCP-induced hyperamylasemia. Total
forty-two
patients who underwent ERCP for diagnostic purposes were included an randomly divided into two groups, non-pretreatment group(NP group, 19 patients) and pretreatment group(P group, 23 patients pretreated with vitamin E 1000 I.U. and allpurinol
300
mg
for 5 days before ERCP orally). 15 ml of venous bloods were drawn in EDTA treated tubes. Serial changes of serum amylase levels(U/ml), washed RBC malonyldialdchyde levels(MDA, nmol/ml RBC), buffy coats myeloperoxidase activites(MPO, U/ml buffy
coats).
And plasma superoxide dismutase levels (SOD, U/ml) were measured before, 2 and 24 hours after ERCP, respectively. Serum amylase levels in P group were decreased than NP group, but without statistical significance. The mean RBC MDA levels of P
group
measured 2 hr after ERCP were 3.43±1.13, which were significantly decreased than those of NP group(5.27±1.53)(P<0.05). The plasma SOD levels of P group were 17.7±1.8, 20.4±2.2 at before, 2 and 24 hr after ERCP, respectively, which were all
significantly decreased than those of NP group(P<0.05). The buffy coats MPO activities were not changed at all in spite of pretreatment. In conclusion, OFR's might be in volved in the pathogenesis of ERCP-induced hyperamylasemia, but do not play
a
major
role. A protective effect of allopurinol and vitamin E could be expected.
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