Plasmapheresis in the treatment of an acute pancreatitis due to protease inhibitor-induced hypertriglyceridemia

2001 ◽  
Vol 16 (3) ◽  
pp. 157-159 ◽  
Author(s):  
Jean-Pierre Routy ◽  
Graham H.R. Smith ◽  
David W. Blank ◽  
Brian M. Gilfix
Keyword(s):  
Acute Pancreatitis ◽  
Protease Inhibitor

Effect of continuous arterial infusion of protease inhibitor on experimental acute pancreatitis

1989 ◽  
Vol 24 (4) ◽  
pp. 448-448 ◽  
Author(s):  
Yoichiro Kakugawa ◽  
Kazunori Takeda ◽  
Masao Kobari ◽  
Seiki Matsuno
Keyword(s):  
Acute Pancreatitis ◽  
Protease Inhibitor ◽  
Experimental Acute Pancreatitis ◽  
Arterial Infusion

scholarly journals Continuous regional arterial infusion versus intravenous administration of the protease inhibitor nafamostat mesilate for predicted severe acute pancreatitis: a multicenter, randomized, open-label, phase 2 trial

2019 ◽  
Vol 55 (3) ◽  
pp. 342-352 ◽  
Author(s):  
Morihisa Hirota ◽  
Tooru Shimosegawa ◽  
Katsuya Kitamura ◽  
Kazunori Takeda ◽  
Yoshifumi Takeyama ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Protease Inhibitor ◽  
Severe Acute Pancreatitis ◽  
Analgesic Effect ◽  
Pancreatic Necrosis ◽  
Controlled Trial ◽  
Nafamostat Mesilate ◽  
Open Label ◽  
Arterial Infusion ◽  
Continuous Regional Arterial Infusion

Abstract Background Continuous regional arterial infusion (CRAI) of protease inhibitor nafamostat mesilate (NM) is used in the context of predicted severe acute pancreatitis (SAP) to prevent the development of pancreatic necrosis. Although this therapy is well known in Japan, its efficacy and safety remain unclear. Methods This investigator-initiated and -driven, multicenter, open-label, randomized, controlled trial (UMIN000020868) enrolled 39 patients with predicted SAP and low enhancement of the pancreatic parenchyma on computed tomography (CT). Twenty patients were assigned to the CRAI group, while 19 served as controls and were administered NM at the same dose intravenously (IV group). The primary endpoint was the development of pancreatic necrosis as determined by CT on Day 14, judged by blinded central review. Results There was no difference between the CRAI and IV groups regarding the percentages of participants who developed pancreatic necrosis (more than 1/3 of the pancreas: 25.0%, range 8.7–49.1% vs. 15.8%, range 3.4–39.6%, respectively, P = 0.694; more than 2/3 of the pancreas: 20%, range 5.7–43.7% vs. 5.3%, range 0.1–26.0%, respectively, P = 0.341). The early analgesic effect was evaluated based on 24-h cumulative fentanyl consumption and additional administration by intravenous patient-controlled analgesia. The results showed that the CRAI group used significantly less analgesic. There were two adverse events related to CRAI, namely bleeding and splenic infarction. Conclusions CRAI with NM did not inhibit the development of pancreatic necrosis although early analgesic effect of CRAI was superior to that of IV. Less-invasive IV therapy can be considered a viable alternative to CRAI therapy.

scholarly journals Alpha-1 protease inhibitor and antichymotrypsin levels in acute pancreatitis

2012 ◽  
Vol 18 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Tamer Karsidag ◽  
Sefa Tuzun ◽  
Ahu Sarbay Kemik ◽  
Sevim Purisa ◽  
Aytekin Unlu
Keyword(s):  
Acute Pancreatitis ◽  
Protease Inhibitor

scholarly journals Crystal structure of nafamostat dimesylate

2021 ◽  
Vol 77 (10) ◽  
Author(s):  
Isao Fujii
Keyword(s):  
Crystal Structure ◽  
Acute Pancreatitis ◽  
Protease Inhibitor ◽  
Divalent Cation ◽  
Serine Protease Inhibitor ◽  
Ring System ◽  
Structure Activity ◽  
Naphthyl Ring ◽  
Guanidinium Group ◽  
Hydrophilic Region

Nafamostat dimesylate {systematic name: [amino({6-[(4-{[amino(iminiumyl)methyl]amino}phenyl)carbonyloxy]naphthalen-2-yl})methylidene]azanium bis(methanesulfonate)}, C19H19N5O22 +·2CH3O3S−, is a broad-spectrum serine protease inhibitor and has been applied clinically as an anticoagulant agent during hemodialysis and for treatment of severe acute pancreatitis (SAP). Since nafamostat contains flexible moieties, it is necessary to determine the conformation to understand the structure–activity relationships. The divalent cation has a screw-like motif. The guanidinium group is approximately perpendicular to the naphthyl ring system, subtending a dihedral angle of 84.30 (14)°. In the crystal, the nafamostat molecules form columnar structures surrounded by a hydrophilic region.

scholarly journals Effects of E-3123, a new protease inhibitor, on several protease activities and on experimental acute pancreatitis.

1988 ◽  
Vol 91 (5) ◽  
pp. 285-293 ◽  
Author(s):  
Kaname MIYAMOTO ◽  
Ieharu HISHINUMA ◽  
Jun-ichi NAGAKAWA ◽  
Naoko NAGAOKA ◽  
Takashi YAMANAKA ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Protease Inhibitor ◽  
Experimental Acute Pancreatitis
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