Bidirectional Relationship Between Reduced Blood pH and Acute Pancreatitis A Translational Study of Their Noxious Combination /

Acute pancreatitis (AP) is often accompanied by alterations in the acid-base balance, but how blood pH influences the outcome of AP is largely unknown. We studied the association between blood pH and the outcome of AP with meta-analysis of clinical trials, and aimed to discover the causative relatio...

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Bibliographic Details
Main Authors: Rumbus Zoltán
Tóth Emese
Pótó László
Vincze Áron
Veres Gábor
Czakó László
Pótóné Oláh Emőke
Márta Katalin
Mikó Alexandra
Rakonczay Zoltán Jr
Balla Zsolt
Kaszaki József
Földesi Imre
Maléth József
Hegyi Péter
Garami András
Format: Article
Published: 2018
Series:FRONTIERS IN PHYSIOLOGY 9
doi:10.3389/fphys.2018.01360

mtmt:30306914
Online Access:http://publicatio.bibl.u-szeged.hu/14578
Description
Summary:Acute pancreatitis (AP) is often accompanied by alterations in the acid-base balance, but how blood pH influences the outcome of AP is largely unknown. We studied the association between blood pH and the outcome of AP with meta-analysis of clinical trials, and aimed to discover the causative relationship between blood pH and AP in animal models. PubMed, EMBASE, and Cochrane Controlled Trials Registry databases were searched from inception to January 2017. Human studies reporting systemic pH status and outcomes (mortality rate, severity scores, and length of hospital stay) of patient groups with AP were included in the analyses. We developed a new mouse model of chronic metabolic acidosis (MA) and induced mild or severe AP in the mice. Besides laboratory blood testing, the extent of pancreatic edema, necrosis, and leukocyte infiltration were assessed in tissue sections of the mice. Thirteen studies reported sufficient data in patient groups with AP (n = 2,311). Meta-analysis revealed markedly higher mortality, elevated severity scores, and longer hospital stay in AP patients with lower blood pH or base excess (P < 0.001 for all studied outcomes). Meta-regression analysis showed significant negative correlation between blood pH and mortality in severe AP. In our mouse model, pre-existing MA deteriorated the pancreatic damage in mild and severe AP and, vice versa, severe AP further decreased the blood pH of mice with MA. In conclusion, MA worsens the outcome of AP, while severe AP augments the decrease of blood pH. The discovery of this vicious metabolic cycle opens up new therapeutic possibilities in AP.
Physical Description:Paper 1360-14 p.
ISSN:1664-042X