The release of vasoactive substances in acute pancreatitis

Recent studies in this laboratory have shown that smooth muscle stimulating substances can be identified in both experimental and human pancreatitis. These substances have the properties of plasma kinins and most probably represent bradykinin or kallidin. The levels of vasoactive materials found in patients with acute pancreatitis correlate well with the clinical state of the disease. These substances produce extreme vasodilatation and increased permeability when injected into a vascular bed. In addition, they stimulate pain fibers. The intense local edema, pain, ascites and hypotension of acute pancreatitis may be related to the release of proteolytic kinin forming enzymes from the pancreas. An inhibitory substance, “Trasylol,” reduces the concentration of the substances in the peripheral blood and in preliminary studies appears to increase survival time in experimental pancreatitis. In short, release of vasoactive polypeptides may explain some of the singular features of acute pancreatitis.