Protective Effect of Melatonin on Acute Pancreatitis

Melatonin, a product of the pineal gland, is released from the gut mucosa in response to food ingestion. Specific receptors for melatonin have been detected in many gastrointestinal tissues including the pancreas. Melatonin as well as its precursor, L-tryptophan, attenuates the severity of acute pancreatitis and protects the pancreatic tissue from the damage caused by acute inflammation. The beneficial effect of melatonin on acute pancreatitis, which has been reported in many experimental studies and supported by clinical observations, is related to: (1) enhancement of antioxidant defense of the pancreatic tissue, through direct scavenging of toxic radical oxygen (ROS) and nitrogen (RNS) species, (2) preservation of the activity of antioxidant enzymes; such as superoxide dismutase (SOD), catalase (CAT), or glutathione peroxidase (GPx), (3) the decline of pro-inflammatory cytokine tumor necrosis α (TNFα) production, accompanied by stimulation of an anti-inflammatory IL-10, (4) improvement of pancreatic blood flow and decrease of neutrophil infiltration, (5) reduction of apoptosis and necrosis in the inflamed pancreatic tissue, (6) increased production of chaperon protein (HSP60), and (7) promotion of regenerative process in the pancreas. Conclusion. Endogenous melatonin produced from L-tryptophan could be one of the native mechanisms protecting the pancreas from acute damage and accelerating regeneration of this gland. The beneficial effects of melatonin shown in experimental studies suggest that melatonin ought to be employed in the clinical trials as a supportive therapy in acute pancreatitis and could be used in people at high risk for acute pancreatitis to prevent the development of pancreatic inflammation

Knowledge of unpharmacological methods of labor pain softening among lying-in women in Cracow hospitals and their use in practice

Ból jest nieodłącznym elementem porodu. Jego nadmierne odczuwanie wywołuje wiele reakcji negatywnie wpływających na matkę i dziecko. Istnieje potrzeba wypracowania działań zmierzających do zmniejszenia tych odczuć do poziomu akceptowalnego przez rodzącą. Potencjał takiego działania kryją w sobie naturalne metody łagodzenia bólu porodowego. Przedstawienie znajomości zastosowania naturalnych metod łagodzenia bólu porodowego przez kobiety rodzące, a także ich skuteczności. Grupę badaną stanowiło 105 położnic po porodach siłami natury. W badaniach zastosowano metodę sondażu diagnostycznego oraz wykorzystano autorski kwestionariusz ankiety. Dane zostały opracowane w programie Statistica 5.0, a hipotezy przetestowano na poziomie istotności p = 0,05. Znajomość metod łagodzenia bólu porodowego przez rodzące nie zależy od wieku, liczby porodów czy miejsca zamieszkania, lecz wzrasta proporcjonalnie wraz z poziomem wykształcenia. Ciężarne czerpią wiedzę na ten temat od członków rodziny i znajomych oraz mediów. Personel medyczny jako źródło informacji stanowi zdecydowaną mniejszość. Rodzące wykorzystują niewielką cześć naturalnych metod łagodzenia bólu, to jest immersję wodną, ruch i pozycje wertykalne, świadome oddychanie oraz wsparcie osoby bliskiej. Istnieją także metody, z których nie korzysta żadna z respondentek. Są to między innymi wsparcie douli, TENS, akupunktura. Kobiety, które stosują podczas porodu naturalne metody, deklarują, że w przyszłości chcą również odbyć poród bez korzystania z metod farmakologicznych. Potencjał naturalnych metod łagodzenia bólu porodowego nie jest w pełni wykorzystywany przez kobiety rodzące, co wynika z braku jednoznacznych dowodów potwierdzających skuteczność tych metod oraz korzystania przez ciężarne z nieprofesjonalnych źródeł informacji na ten temat.Pain is an inseparable element of labor. Its excessive feeling elicits a number of negative reactions affected on mother and child. Therefrom exist the necessity to elaborate the activities aimed to decrease of this feeling to the acceptable level of women in labor. There is a potential in natural methods of labor pain softening. Performance of knowledge and application of natural methods of labor pain softening and the assessment of this methods efficacy. The study group consisted of 105 women in labor, after natural birth. The method of diagnostic survey and original questionnaire were applied in the study. All data were analyzed using Statistica version 5.0 (p = 0.05). Knowledge about methods of labor pain softening does not depend on age, number of births or place of residence but increases proportionally with the level of education. Pregnant women makes use of unprofessional sources such as members of family, friends and from media. Medical staff as an information source provides determined minority. Delivered women using slight part of natural methods of pain softening such us: water immersion, movement and vertical poses, aware breathing and the assistance of loved one. The potential of natural methods of labor pain softening isn’t fully exploited by the women in labor. It could resulted from the lack of clear arguments which affirm the efficacy of this methods and using unprofessional sources about this theme by pregnant women

Molecular ghrelin system in the pancreatic acinar cells : the role of the polypeptide, caerulein and sensory nerves

Ghrelin (GHRL) is an endogenous ligand for the growth hormone secretagogue receptor (GHS-R). Experimental studies showed that GHRL protects the stomach and pancreas against acute damage, but the effect of GHRL on pancreatic acinar cells was still undetermined. Aim: To investigate the effect of GHRL and caerulein on the functional ghrelin system in pancreatic acinar cells taking into account the role of sensory nerves (SN). Methods: Experiments were carried out on isolated pancreatic acinar cells and AR42J cells. Before acinar cells isolation, GHRL was administered intraperitoneally at a dose of 50 µg/kg to rats with intact SN or with capsaicin deactivation of SN (CDSN). After isolation, pancreatic acinar cells were incubated in caerulein-free or caerulein containing solution. AR42J cells were incubated under basal conditions and stimulated with caerulein, GHRL or a combination of the above. Results: Incubation of isolated acinar cells with caerulein inhibited GHS-R and GHRL expression at the level of mRNA and protein in those cells. Either in rats with intact SN or with CDSN, administration of GHRL before isolation of acinar cells increased expression of GHRL and GHS-R in those cells and reversed the caerulein-induced reduction in expression of those parameters. Similar upregulation of GHS-R and GHRL was observed after administration of GHRL in AR42J cells. Conclusions: GHRL stimulates its own expression and expression of its receptor in isolated pancreatic acinar cells and AR42J cells on the positive feedback pathway. This mechanism seems to participate in the pancreatoprotective effect of GHRL in the course of acute pancreatitis

Capsaicin-sensitive sensory nerves are necessary for the protective effect of ghrelin in cerulein-induced acute pancreatitis in rats

Ghrelin was shown to exhibit protective and therapeutic effect in the gut. Aim of the study was to investigate the role of sensory nerves (SN) in the protective effect of ghrelin in acute pancreatitis (AP). Studies were performed on male Wistar rats or isolated pancreatic acinar cells. After capsaicin deactivation of sensory nerves (CDSN) or treatment with saline, rats were pretreated intraperitoneally with ghrelin or saline. In those rats, AP was induced by cerulein or pancreases were used for isolation of pancreatic acinar cells. Pancreatic acinar cells were incubated in cerulein-free or cerulein containing solution. In rats with intact SN, pretreatment with ghrelin led to a reversal of the cerulein-induced increase in pancreatic weight, plasma activity of lipase and plasma concentration of tumor necrosis factor-α (TNF-α). These effects were associated with an increase in plasma interleukin-4 concentration and reduction in histological signs of pancreatic damage. CDSN tended to increase the severity of AP and abolished the protective effect of ghrelin. Exposure of pancreatic acinar cells to cerulein led to increase in cellular expression of mRNA for TNF-α and cellular synthesis of this cytokine. Pretreatment with ghrelin reduced this alteration, but this effect was only observed in acinar cells obtained from rats with intact SN. Moreover, CDSN inhibited the cerulein- and ghrelin-induced increase in gene expression and synthesis of heat shock protein 70 (HSP70) in those cells. Ghrelin exhibits the protective effect in cerulein-induced AP on the organ and pancreatic acinar cell level. Sensory nerves ablation abolishes this effect

Melatonin influences pancreatic cancerogenesis

Pancreatic cancer has fatal prognosis because of the absence of early symptoms, late diagnosis and the resistance to radio- and chemotherapy. Melatonin, an indoleamine discovered in the pineal gland, has also been detected in the gastrointestinal system and its specific receptors have been identified in the pancreas. Some evidence indicates that melatonin could modulate the process of pancreatic oncogenesis: 1) Melatonin, as direct scavenger of radical oxygen and nitrogen species (ROS and RNS) and activator of antioxidant enzymes effectively protects the pancreatic tissue against oxidative stress and inflammatory damage. 2) In pancreatic carcinoma cell line (PANC-1) melatonin used at high doses affects the Bax/Bcl protein balance, and stimulates the expressions of caspase-9 and caspase-3, thus activating the mitochondrial pathway of apoptosis. On the contrary, low concentrations of melatonin turn on the production of anti-apoptotic heat shock proteins: HSP27, HSP70, and HSP90, which prevents the activation of caspase-3. 3) Melatonin reduces angiogenesis and decreases proliferation of endothelial cells through inhibition of vascular endothelial factor (VEGF). 4) Melatonin strengthens the immune defense of the organism via activation of peripheral effector T cells and suppression of T regulatory cells. 5) In animal studies melatonin has been found to increase the efficacy of oncostatic drugs, to reduce the side effects of chemotherapy and to decrease morbidity. These observations suggest that melatonin at high doses could be potentially taken into consideration as the supportive treatment in the therapy of pancreatic cancer, although the effect of melatonin on apoptosis requires further study. Histol Histopathol 29, 423-431 (2014