Name: sodium taurocholate induced severe acute pancreatitis in c57bl/6 mice
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Os autores agradecem ao Programa de Pós-Graduação em Clínica Médica da Universidade de São Paulo; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Faculdade de Medicina da Universidade de São Paulo (FMUSP).

Este protocolo foi aprovado pelo Comitê de Ética para o uso de animais da Faculdade de Medicina da USP, Num. Projeto: 1343/2019-CEUA: FMUSP. Para este protocolo, foram utilizados camundongos C57BL/6, com idade de 6 semanas, pesando 20 ± 2 g (n = 9/grupo).
1. Laparotomia
<ol><li>Anestesize animais com xilazina (10 mg/kg) e solução de cetamina (80 mg/kg), subcutânea (0,1 mL/10g de peso corporal) utilizando uma seringa de 1 mL e agulha de 13x0,45mm 26G 1/2. Verifique se há profundidade d...

<ol>
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L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Induction+of+antioxidant+mechanisms+in+lung+during+experimental+pancreatitis+in+rats.">Induction of antioxidant mechanisms in lung during experimental pancreatitis in rats.</a> Indian Journal of Experimental Biology. 58 (5), 297-305 (2020).</li><li>T, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraductal+infusion+of+taurocholate+followed+by+distal+common+bile+duct+ligation+leads+to+a+severe+necrotic+model+of+pancreatitis+in+mice.">Intraductal infusion of taurocholate followed by distal common bile duct ligation leads to a severe necrotic model of pancreatitis in mice.</a> Pancreas. 44 (3), (2015).</li><li>Botoi, G., Andercou, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interleukin+17-prognostic+marker+of+severe+acute+pancreatitis.">Interleukin 17-prognostic marker of severe acute pancreatitis.</a> Chirurgia. 104 (4), 431-438 (2009).</li><li>Li, D., Li, J., Wang, L., Zhang, Q. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Association+between+IL-1beta,+IL-8,+and+IL-10+polymorphisms+and+risk+of+acute+pancreatitis.">Association between IL-1beta, IL-8, and IL-10 polymorphisms and risk of acute pancreatitis.</a> Genetics and Molecular Research. 14 (2), 6635-6641 (2015).</li><li>Feng, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+peritoneal+lavage+with+ulinastatin+on+the+expression+of+NF-kappaB+and+TNF-alpha+in+multiple+organs+of+rats+with+severe+acute+pancreatitis.">Effect of peritoneal lavage with ulinastatin on the expression of NF-kappaB and TNF-alpha in multiple organs of rats with severe acute pancreatitis.</a> Experimental and Therapeutic Medicine. 10 (6), 2029-2034 (2015).</li><li>Fang, D. Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+sildenafil+on+inflammatory+injury+of+the+lung+in+sodium+taurocholate-induced+severe+acute+pancreatitis+rats.">Effects of sildenafil on inflammatory injury of the lung in sodium taurocholate-induced severe acute pancreatitis rats.</a> International Immunopharmacology. 80, (2020).</li><li>Ceranowicz, P., Cieszkowski, J., Warzecha, Z., Dembinski, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+models+of+acute+pancreatitis.">Experimental models of acute pancreatitis.</a> Post&#281;py Higieny i Medycyny Do&#347;wiadczalnej(Online). 69, 264-269 (2015).</li><li>Wan, M. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Review+of+experimental+animal+models+of+biliary+acute+pancreatitis+and+recent+advances+in+basic+research.">Review of experimental animal models of biliary acute pancreatitis and recent advances in basic research.</a> HPB (Oxford). 14 (2), 73-81 (2012).</li><li>Mayerle, J., Sendler, M., Lerch, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Secretagogue+(Caerulein)+induced+pancreatitis+in+rodents.">Secretagogue (Caerulein) induced pancreatitis in rodents.</a> Pancreapedia: The Exocrine Pancreas Knowledge Base. (1), (2013).</li><li>Wang, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resveratrol+protects+against+L-arginine-induced+acute+necrotizing+pancreatitis+in+mice+by+enhancing+SIRT1-mediated+deacetylation+of+p53+and+heat+shock+factor+1.">Resveratrol protects against L-arginine-induced acute necrotizing pancreatitis in mice by enhancing SIRT1-mediated deacetylation of p53 and heat shock factor 1.</a> International Journal of Molecular Medicine. 40 (2), 427-437 (2017).</li><li>Ma, Z. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+resveratrol+on+peritoneal+macrophages+in+rats+with+severe+acute+pancreatitis.">Effect of resveratrol on peritoneal macrophages in rats with severe acute pancreatitis.</a> Inflammation Research. 54 (12), 522-527 (2005).</li><li>Souza, L. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anti-inflammatory+effects+of+peritoneal+lavage+in+acute+pancreatitis.">Anti-inflammatory effects of peritoneal lavage in acute pancreatitis.</a> Pancreas. 39 (8), 1180-1184 (2010).</li><li>Perides, G., Acker, G. J. v., Laukkarinen, J. M., Steer, M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+acute+biliary+pancreatitis+induced+by+retrograde+infusion+of+bile+acids+into+the+mouse+pancreatic+duct.">Experimental acute biliary pancreatitis induced by retrograde infusion of bile acids into the mouse pancreatic duct.</a> Nature Protocols. 5 (2), 335-341 (2010).</li><li>Wittel, U. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Taurocholate-induced+pancreatitis:+a+model+of+severe+necrotizing+pancreatitis+in+mice.">Taurocholate-induced pancreatitis: a model of severe necrotizing pancreatitis in mice.</a> Pancreas. 36 (2), 9-21 (2008).</li><li>Tao, L., Reese, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Making+mouse+models+that+reflect+human+immune+responses.">Making mouse models that reflect human immune responses.</a> Trends Immunology. 38 (3), 181-193 (2017).</li><li>Vandamme, T. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+rodents+as+models+of+human+diseases.">Use of rodents as models of human diseases.</a> Journal of Pharmacy and Bioallied Science. 6 (1), 2-9 (2014).</li><li>Song, H. K., Hwang, D. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+C57BL/6N+mice+on+the+variety+of+immunological+researches.">Use of C57BL/6N mice on the variety of immunological researches.</a> Laboratory Animal Research. 33 (2), 119-123 (2017).</li><li>Bogdanske, J. J., Stelle, S. H. -. V., Riley, M. V., Schiffman, B. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Suturing Principles and Techniques in Laboratory Animal Surgery. 1st edition. (1), (2010).</li><li>Ray, A., Dittel, B. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolation+of+mouse+peritoneal+cavity+cells.">Isolation of mouse peritoneal cavity cells.</a> Journal of Visualized Experiments. (35), e1488 (2010).</li><li>Schmidt, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+better+model+of+acute+pancreatitis+for+evaluating+therapy.">A better model of acute pancreatitis for evaluating therapy.</a> Annals of Surgery. 215 (1), 44-56 (1992).</li><li>Liu, D. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resveratrol+improves+the+therapeutic+efficacy+of+bone+marrow-derived+mesenchymal+stem+cells+in+rats+with+severe+acute+pancreatitis.">Resveratrol improves the therapeutic efficacy of bone marrow-derived mesenchymal stem cells in rats with severe acute pancreatitis.</a> International Immunopharmacology. 80, 106128 (2020).</li><li>Yang, X. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chaiqin+chengqi+decoction+alleviates+severe+acute+pancreatitis+associated+acute+kidney+injury+by+inhibiting+endoplasmic+reticulum+stress+and+subsequent+apoptosis.">Chaiqin chengqi decoction alleviates severe acute pancreatitis associated acute kidney injury by inhibiting endoplasmic reticulum stress and subsequent apoptosis.</a> Biomedicine &amp; Pharmacotherapy. 125 (12), 110024 (2020).</li><li>Yang, X. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chaiqin+chengqi+decoction+alleviates+severe+acute+pancreatitis+associated+acute+kidney+injury+by+inhibiting+endoplasmic+reticulum+stress+and+subsequent+apoptosis.">Chaiqin chengqi decoction alleviates severe acute pancreatitis associated acute kidney injury by inhibiting endoplasmic reticulum stress and subsequent apoptosis.</a> Biomedicine &amp; Pharmacotherapy. 125, 110024 (2020).</li><li>Venglovecz, V., Z, R., Hegyi, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+bile+acids+on+pancreatic+ductal+cells.">The effects of bile acids on pancreatic ductal cells.</a> Pancreapedia: The Exocrine Pancreas Knowledge Base. (1), (2019).</li><li>Roberts, S. E., Akbari, A., Thorne, K., Atkinson, M., Evans, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+incidence+of+acute+pancreatitis:+impact+of+social+deprivation,+alcohol+consumption,+seasonal+and+demographic+factors.">The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors.</a> Alimentary Pharmacology and Therapeutics. 38 (5), 539-548 (2013).</li><li>Lerch, M. M., Gorelick, F. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Models+of+acute+and+chronic+pancreatitis.">Models of acute and chronic pancreatitis.</a> Gastroenterology. 144 (6), 1180-1193 (2013).</li><li>Nakamura, K., Fukatsu, K., Sasayama, A., Yamaji, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+immune-modulating+formula+comprising+whey+peptides+and+fermented+milk+improves+inflammation-related+remote+organ+injuries+in+diet-induced+acute+pancreatitis+in+mice.">An immune-modulating formula comprising whey peptides and fermented milk improves inflammation-related remote organ injuries in diet-induced acute pancreatitis in mice.</a> Biosci Microbiota Food Health. 37 (1), 1-8 (2018).</li><li>Kui, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+insights+into+the+methodolgy+of+L-Arginine-induced+acute+pancreatitis.">New insights into the methodolgy of L-Arginine-induced acute pancreatitis.</a> PLoS One. 10 (2), 011758 (2015).</li><li>Xue, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alternatively+activated+macrophages+promote+pancreatic+fibrosis+in+chronic+pancreatitis.">Alternatively activated macrophages promote pancreatic fibrosis in chronic pancreatitis.</a> Nature Communication. 6, 7158 (2015).</li><li>Lesina, M., Wormann, S. M., Neuhofer, P., Song, L., Algul, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interleukin-6+in+inflammatory+and+malignant+diseases+of+the+pancreas.">Interleukin-6 in inflammatory and malignant diseases of the pancreas.</a> Seminars in Immunology. 26 (1), 80-87 (2014).</li><li>Rao, S. A., Kunte, A. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interleukin-6:+An+early+predictive+marker+for+severity+of+acute+pancreatitis.">Interleukin-6: An early predictive marker for severity of acute pancreatitis.</a> Indian Journal of Critical Care Medicine. 21 (7), 424-428 (2017).</li></ol>

O método de indução de pancreatite aguda por infusão de taurocholate de sódio retrógrado já foi mostrado em ratos22,23,24. Três trabalhos semelhantes, publicados em 2008, 2010 e 2015, serviram de referência para o protocolo3,14,15. Neste trabalho, listamos todas as etapas críticas para a reprodução deste método em camundong...

Em humanos, a presença de cálculos biliares é a causa mais comum de pancreatite devido à obstrução da porção terminal do choledochal, interrompendo o fluxo de secreções pancreáticas e causando um intenso processo inflamatório no pâncreas, com aumento da concentração de enzimas digestivas no soro e mediadores inflamatórios1,2.
Duas teorias diferentes foram propostas para explicar o desenvolvimento de pancreatite aguda (AP). A teoria do "canal comum" sugere que as pedras presentes na vesícula biliar obstruem o sistema de ducto biliar comum distal, permitindo que a secreção biliar flua retrógrada para o ducto pancreático. A segunda teoria (a teoria da "obstrução do ducto") sugere que a obstrução do ducto pancreático por excesso de cálculos biliares causa um bloqueio no fluxo de secreção pancreática para o duodeno, causando hipertensão ductal3. Embora os mecanismos que levam à pancreatite biliar aguda não sejam totalmente compreendidos, o resultado é um processo inflamatório intenso. Erupção de enzima digestiva e auto-digestão do pâncreas levam a alterações histopatológicas, aumento de citocinas inflamatórias (IL-1β, IL-6, TNF-α) em fluido ascético e soro, e aumento de proteínas de fase aguda4,5,6.
A pancreatite aguda grave é uma condição que merece atenção clínica devido ao envolvimento de múltiplos órgãos e a um alto risco de mortalidade. Modelos animais para a reprodução de pancreatite aguda (AP) são importantes, pois explicam os mecanismos fisiodicosiológicos da doença e ajudam no acompanhamento da evolução dos eventos inflamatórios, a partir dos estágios iniciais da doença. Isso geralmente não é possível nas clínicas2,7. Além disso, o acesso a tecidos pancreáticos é fácil em estudos pré-clínicos, favorecendo a elucidação de alterações ligadas às condições clínicas8, juntamente com a possibilidade de trabalhar com espécies isogênicas, eliminando variáveis indesejáveis e espelhando a semelhança clínica com os desfechos observados na condição humana9.
Modelos biliares e não biliares para a indução de pancreatite aguda em espécies de ratos e camundongos têm sido frequentemente estudados na literatura científica. Os métodos não biliares de indução incluem a administração de doses estimulantes supramaximais da colecistocina secretagogue ou sua cerulein analógica10; administração de doses quase letais de L-arginina; ou administração de uma dieta deficiente de colina suplementada com ethionine11. Embora esses métodos sejam fáceis de reproduzir e resultem em inflamação pancreática, eles não replicam os mecanismos que, em teoria, desencadeiam AP (ou seja, o refluxo da secreção bile no ducto pancreático). A técnica que aborda o modelo biliar baseia-se na infusão retrógrada de ácidos biliares no ducto pancreático e requer pesquisadores bem treinados para realizar este protocolo. Vários estudos foram publicados utilizando esse método em ratos (aparentemente por razões técnicas, uma vez que esses experimentos envolvem procedimentos cirúrgicos)12,13. No entanto, a abordagem em camundongos pode oferecer resultados mais interessantes no estudo da inflamação3,14,15. Neste estudo, mostraremos uma lista dos passos a serem seguidos para a reprodução de pancreatite aguda grave por infusão de taurocolato de sódio em camundongos anestocás C57BL/6.
Para trabalhos que envolvem a necessidade de experimentos com anticorpos e análise da expressão genética e proteica, o uso de camundongos é preferível devido ao maior arsenal de materiais para esses animais e à possibilidade de trabalhar com espécies isogênicas e eliminatórias, entre outras que podem ser utilizadas relevantes para estudos16. Camundongos C57BL/6 é uma variedade de camundongos originalmente desenvolvida para o estudo da atividade antitumoral e imunologia. Essa cepa está cada vez mais sendo preferida pelos pesquisadores por ser isogênica, permitindo uma maior reprodutibilidade de resultados, o que pode implicar o uso de um número menor de animais em um experimento e menor variabilidade dos resultados entre o mesmo grupo17,18.
Perides et al. (2010)14 publicaram um protocolo para indução de AP em camundongos por infusão de taurochoola de sódio. Aqui atualizamos este modelo utilizando uma maior concentração de taurocholate de sódio (2,5%) em camundongos C57BL/6, com volume e velocidade definidos de infusão (Figura 1). O nível máximo de gravidade é alcançado dentro de 12 h de indução em camundongos. A elevação da concentração de IL-6 tanto no soro quanto na cavidade peritoneal está correlacionada com a progressão da AP. Com a prática, o tempo total estimado desde a indução da anestesia até a conclusão da infusão, é de 25 minutos por animal. É essencial que um pesquisador treinado conduza esse experimento. Para garantir que a solução seja injetada corretamente no ducto biliar comum, realize várias sessões de treinamento piloto usando azul de metileno em vez de taurocolato de sódio.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.4 mm needle</td>
			<td>INTRAG MEDICAL TECH</td>
			<td>90183210</td>
			<td>30G</td>
		</tr>
		<tr>
			<td>&#160;0.54 mm polyethylene tube</td>
			<td>Tygon</td>
			<td>730010</td>
			<td>-</td>
		</tr>
		<tr>
			<td>Styrofoam block</td>
			<td>-</td>
			<td>-</td>
			<td>-</td>
		</tr>
		<tr>
			<td>masking tape for mounting the mouse</td>
			<td>Missner</td>
			<td>1236</td>
			<td>-</td>
		</tr>
		<tr>
			<td>Infusion pump scheduled to 10&#181;L / min.</td>
			<td>Havard aparatus-Peristaltic Pump Series</td>
			<td>MA1 55-7766</td>
			<td>&#160;Model 66 Small Peristaltic</td>
		</tr>
		<tr>
			<td>Scissors and forceps</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Antiseptic providine iodine</td>
			<td>Pfizer</td>
			<td>12086OR</td>
			<td>antisepsis</td>
		</tr>
		<tr>
			<td>70% ethanol</td>
			<td>SIGMA</td>
			<td>459836</td>
			<td>Mix 700 mL 100% ethanol with 300 mL dH2O</td>
		</tr>
		<tr>
			<td>Razor blade</td>
			<td>Lord</td>
			<td>bdk9a1ghk6</td>
			<td>For trichotomy</td>
		</tr>
		<tr>
			<td>Sodium taurocholate</td>
			<td>Sigma-Aldrich</td>
			<td>86339- 1G</td>
			<td>CAS NUMBER- 345909-26-4</td>
		</tr>
		<tr>
			<td>microvessel clip</td>
			<td>Medicon Surgical</td>
			<td>56.87.35</td>
			<td>Approximator, opening 4.0 mm, closing pressure 30 -&#160;40 g</td>
		</tr>
		<tr>
			<td>6-0 prolene</td>
			<td>Bioline</td>
			<td>5162</td>
			<td>Suture line</td>
		</tr>
		<tr>
			<td>Ketamin NP (cloridrato de dextrocetamina) 50mg/mL</td>
			<td>Crist&#225;lia</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Xilazine 2%</td>
			<td>Syntec</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile saline solution (0.9% (wt/vol) saline)</td>
			<td>Farmace</td>
			<td>105851</td>
			<td></td>
		</tr>
		<tr>
			<td>Methyl Blue</td>
			<td>Sigma-Aldrich Chemicals</td>
			<td>M5528</td>
			<td></td>
		</tr>
		<tr>
			<td>MILLIPLEX&#160;MAP&#160;Mouse Cytokine/Chemokine Magnetic Bead Panel - Immunology Multiplex Assay</td>
			<td>MERCK</td>
			<td>MCYTOMAG-70K</td>
			<td>Simultaneously analyze multiple cytokine and chemokine biomarkers with Bead-Based Multiplex Assays using the Luminex technology, in mouse serum, plasma and cell culture samples.</td>
		</tr>
		<tr>
			<td>Amylase Assay</td>
			<td>Labtest</td>
			<td>11</td>
			<td></td>
		</tr>
		<tr>
			<td>Desmarres retractor 13-mm 
			width</td>
			<td>ROBOZ</td>
			<td>RS-6672</td>
			<td></td>
		</tr>
	</tbody>
</table>

sodium taurocholate induced severe acute pancreatitis in c57bl/6 mice

A indução de pancreatite aguda biliar por infusão de taurocoolato de sódio tem sido amplamente utilizada pela comunidade científica devido à representação da condição clínica humana e à reprodução de eventos inflamatórios correspondentes ao aparecimento de pancreatite biliar clínica. A gravidade dos danos pancreáticos pode ser avaliada medindo a concentração, velocidade e volume do ácido biliar infundido. Este estudo fornece uma lista atualizada dos materiais e métodos utilizados na reprodução do protocolo e mostra os principais resultados deste modelo de pancreatite aguda (AP). A maioria das publicações anteriores limitou-se a reproduzir esse modelo em ratos. Aplicamos esse método em camundongos, o que proporciona vantagens adicionais (ou seja, a disponibilidade de um arsenal de reagentes e anticorpos para esses animais, juntamente com a possibilidade de trabalhar com cepas geneticamente modificadas de camundongos) que podem ser relevantes para o estudo. Para indução aguda de pancreatite em camundongos, apresentamos um protocolo sistemático, com uma dose definida de 2,5% de taurocolato de sódio a uma velocidade de infusão de 10 μL/min por 3 min em camundongos C57BL/6 que atinge seu nível máximo de gravidade dentro de 12 h de indução e destacam resultados com resultados que validam o método. Com a prática e a técnica, o tempo total estimado, desde a indução da anestesia até a conclusão da infusão, é de 25 minutos por animal.

A gravidade da pancreatite foi pontuada entre 0-3 de acordo com a escala de Schmidt21 , onde zero corresponde à ausência, 1 corresponde a uma presença leve (<25%), 2 corresponde a uma presença moderada (entre 25 e 50%) e 3 corresponde a uma presença intensa (> 50%) (Tabela 1). As medidas realizadas foram atividade de amilase plasmática, edema pancreático, célula acinar, lesão/necrose, inflamação pancreática (por análise histologia de s...

Watch this Scientific Journal Video about Sodium Taurocholate Induced Severe Acute Pancreatitis in C57BL/6 Mice at JoVE.com

Sodium Taurocholate Induced Severe Acute Pancreatitis in C57BL/6 Mice

Modelos animais para pancreatite aguda grave permitem o estudo de alterações fisiodicosiológicas no estágio inicial, facilitando a observação da evolução dos eventos inflamatórios. Aqui fornecemos um protocolo para a indução de pancreatite biliar aguda grave por infusão retrógrada de taurocholate de sódio no ducto pancreático de camundongos C57BL/6 anestesiados.

Taurocholate de sódio induziu pancreatite aguda grave em C57BL/6 camundongos

Biliary acute pancreatitis induction by sodium taurocholate infusion has been widely used by the scientific community due to the representation of the ...

Este método pode ser usado para reproduzir os eventos inflamatórios que ocorrem na pancreatite biliar aguda. É possível estudar alterações no tecido pancreático em seus estágios iniciais, o que geralmente não é possível na clínica. As principais vantagens dessa técnica são que ela é rápida e fácil de reproduzir para um pesquisador treinado, e oferece resultados semelhantes à pancreatite aguda em humanos.O método pode ser usado para estudar respostas imunes farmacológicas de moléculas de drogas e outras intervenções terapêuticas, pois permite o estudo de células inflamatórias mediadores no pâncreas e órgãos adjacentes. Ao tentar esse protocolo, localizar os órgãos e estabelecer a região de cannulação é crucial. Memorize a localização dos órgãos e exerça a aplicação da injeção primeiro usando uma solução colorida como azul metileno.Depois de verificar a profundidade da anestesia com uma pitada de dedo do dedo do dedo, limpe a área abdominal de um rato anestesiado com uma solução de iodo povidone de 5%. Usando um aparador, remova o cabelo entre o peito e o abdômen inferior e limpe uma área cirúrgica de aproximadamente dois centímetros quadrados com 70% de álcool. Imobilize o animal na placa cirúrgica e use uma tesoura para cortar cinco milímetros da pele horizontalmente na parte superior do abdômen e um centímetro abaixo do processo xifoide.Repita o corte no peritônio para realizar a laparotomia com exposição mínima da cavidade. Usando um retrátil, puxe o fígado em direção à cabeça a aproximadamente um centímetro do intestino e localize a região do pâncreas e do duodeno. Usando fórceps, levante o fígado em direção à cabeça do animal.Puxando suavemente a porção do intestino delgado, fixar as duas extremidades laterais com uma sutura de polipropileno 6-0 para uma melhor visão da porção distal do ducto biliar comum também. Usando um clipe de micro vaso, oclui temporariamente o ducto biliar comum proximal. Expor o órgão da cavidade abdominal.Em seguida, faça uma oclusão temporária do ducto biliar comum distal com um 8-0 sutura. Para acessar o ducto biliar comum, perfure a região periampulária, que aparece como uma parte esbranquiçada da parede do intestino delgado. Com uma agulha de 0,4 milímetros conectada a um tubo de polietileno de 0,54 milímetros, inicie a bomba de infusão para infusão de 2,5% de infusão de solução taurocholate de sódio a uma velocidade constante de 10 microliters por 10 gramas de peso corporal por três minutos.Após a infusão, remova o clipe do micro vaso, o 8-0 temporário sutura, ea agulha de injeção do ducto biliar pancreático. Sutura o abdômen com uma sutura de polipropileno monoboxileno nãoabsorbente 6-0. O tempo entre a laparotomia e a sutura final não deve ser superior a 30 minutos.Após a cirurgia, abriga os animais em caixas de polietileno forradas com aparas de madeira e água e ad libitum alimentar. Segure suavemente o animal com a pele puxada para trás, promovendo uma leve saliência do globo ocular, e posicione o animal com o olho voltado para cima. Incutir um gota de pomada ocular contendo anestésico local no olho do animal.Posicione a extremidade de um tubo capilar no canto medial do olho e insira-o suavemente sob o globo ocular em um ângulo de aproximadamente 30 a 45 graus. Gire o tubo capilar até que o fluxo sanguíneo comece. Uma vez que a coleção acabou, certifique-se de homeostase mantendo as pálpebras fechadas com compressão leve.Mais tarde, usando uma agulha calibre 27, injete quatro mililitros de PBS gelado na cavidade peritoneal do rato. Após a injeção, massageie suavemente o peritônio por 10 segundos para remover as células aderidas. Usando tesouras e pinças, faça um pequeno corte de 0,5 centímetros na pele interna e musculatura para expor a cavidade abdominal.Insira uma pipeta de bulbo no peritônio e colete o máximo de fluido possível, tomando cuidado para não aspirar tecido gorduroso. Recolhe uma parte do pâncreas da região principal para posterior processamento. Deposite o fluido coletado em tubos mantidos no gelo.Em seguida, centrifugar o fluido peritoneal a 250 vezes G por cinco minutos e estocar o supernatante para dosagem interleucina-6. Para obter soro, centrifugar as amostras de sangue coletadas a 700 vezes G durante 15 minutos e estocar o sobrenatante para amilase e dosagem interleucina-6. A análise do tecido pancreático 12 horas após a indução de pancreatite aguda mostrou inflamação intensa no órgão afetado quando comparada com amostras de tecido do grupo sham.Resultados semelhantes foram representados por exame histológico após a coloração de eosina de hematoxilina de amostras de tecido de sham e APTA. A análise do soro sanguíneo apresentou um aumento significativo na concentração de amilase sérico e interleucina-6 no grupo AP em comparação com o grupo sham. Ao mesmo tempo, a concentração interleucina-6 foi significativamente maior no fluido de cavidade peritoneal no grupo AP.A gravidade da pancreatite neste modelo depende proporcionalmente da concentração, do volume e da pressão da infusão e do tempo de indução aguda da pancreatite. Com a ajuda dessa técnica, podem ser estudados os efeitos da lavagem peritoneal contínua na pancreatite aguda grave.

sodium-taurocholate-induced-severe-acute-pancreatitis-in-c57bl6-mice

Research

JoVE Journal

Medicine

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

Carbon dioxide (CO2) along with oxygen (O2) share the role of being the most important gases in the human body. The measuring of expired CO2 at the mouth has solicited growing clinical interest among physicians in the emergency department for various indications: (1) surveillance et monitoring of the intubated patient; (2) verification of the correct positioning of an endotracheal tube; (3) monitoring of a patient in cardiac arrest; (4) achieving normocapnia in intubated head trauma patients; (5) monitoring ventilation during procedural sedation. The video allows physicians to familiarize themselves with the use of capnography and the text offers a review of the theory and principals involved. In particular, the importance of CO2 for the organism, the relevance of measuring expired CO2, the differences between arterial and expired CO2, the material used in capnography with their artifacts and traps, will be reviewed. Since the main reluctance in the use of expired CO2 measurement is due to lack of correct knowledge concerning the physiopathology of CO2 by the physician, we hope that this explanation and the video sequences accompanying will help resolve this limitation.

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

This video describes how to perform CO2 measurement in intubated as well as spontaneously breathing patients. The main clinical indications refer to emergency situations: (1) verifying adequate positioning of an endotracheal tube; (2) achieving normocapnia in trauma patients; (3) monitoring ventilation in the case of procedural sedation.

CO expirado 2 Medição em pacientes entubados com respiração espontânea ou do Departamento de Emergência

Carbon dioxide (CO2) along with oxygen (O2) share the role of being the most important gases in the human body. The measuring of expired CO2 at the mouth ...

Medicina

Pressure Controlled Ventilation to Induce Acute Lung Injury in Mice

Murine models are extensively used to investigate acute injuries of different organs systems (1-34). Acute lung injury (ALI), which occurs with prolonged mechanical ventilation, contributes to morbidity and mortality of critical illness, and studies on novel genetic or pharmacological targets are areas of intense investigation (1-3, 5, 8, 26, 30, 33-36). ALI is defined by the acute onset of the disease, which leads to non-cardiac pulmonary edema and subsequent impairment of pulmonary gas exchange (36). We have developed a murine model of ALI by using a pressure-controlled ventilation to induce ventilator-induced lung injury (2). For this purpose, C57BL/6 mice are anesthetized and a tracheotomy is performed followed by induction of ALI via mechanical ventilation. Mice are ventilated in a pressure-controlled setting with an inspiratory peak pressure of 45 mbar over 1 - 3 hours. As outcome parameters, pulmonary edema (wet-to-dry ratio), bronchoalveolar fluid albumin content, bronchoalveolar fluid and pulmonary tissue myeloperoxidase content and pulmonary gas exchange are assessed (2). Using this technique we could show that it sufficiently induces acute lung inflammation and can distinguish between different treatment groups or genotypes (1-3, 5). Therefore this technique may be helpful for researchers who pursue molecular mechanisms involved in ALI using a genetic approach in mice with gene-targeted deletion.

A murine model for ventilator induced lung injury is an important tool to study an acute lung injury in vivo. Here, we report an easy applicable in situ model for acute lung injury using high-pressure mechanical ventilation to induce acute failure of the lung.

Ventilação a pressão controlada para induzir lesão pulmonar aguda em ratos

Murine models are extensively used to investigate acute injuries of different organs systems (1-34). Acute lung injury (ALI), which occurs with prolonged ...

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Ischemia-reperfusion induced acute kidney injury (IR-AKI) is widely used as a model of AKI in mice, but results are often quite variable with high, often unreported mortality rates that may confound analyses. Bilateral renal pedicle clamping is commonly used to induce IR-AKI, but differences between effective clamp pressures and/or renal responses to ischemia between kidneys often lead to more variable results. In addition, shorter clamp times are known to induce more variable tubular injury, and while mice undergoing bilateral injury with longer clamp times develop more consistent tubular injury, they often die within the first 3 days after injury due to severe renal insufficiency. To improve post-injury survival and obtain more consistent and predictable results, we have developed two models of unilateral ischemia-reperfusion injury followed by contralateral nephrectomy. Both surgeries are performed using a dorsal approach, reducing surgical stress resulting from ventral laparotomy, commonly used for mouse IR-AKI surgeries. For induction of moderate injury BALB/c mice undergo unilateral clamping of the renal pedicle for 26 min and also undergo simultaneous contralateral nephrectomy. Using this approach, 50-60% of mice develop moderate AKI 24 hr after injury but 90-100% of mice survive. To induce more severe AKI, BALB/c mice undergo renal pedicle clamping for 30 min followed by contralateral nephrectomy 8 days after injury. This allows functional assessment of renal recovery after injury with 90-100% survival. Early post-injury tubular damage as well as post injury fibrosis are highly consistent using this model.

We describe models of moderate and severe ischemia-reperfusion-induced kidney injury in which the mice undergo unilateral renal pedicle clamping followed by simultaneous or delayed contralateral nephrectomy, respectively. These models consistently give rise to renal dysfunction and post-injury fibrosis, but injury severity and survival are dependent on mouse background, age and surgical equipment.

Isquemia-reperfusão modelo de lesão renal aguda e Pós Lesão fibrose em camundongos

Ischemia-reperfusion induced acute kidney injury (IR-AKI) is widely used as a model of AKI in mice, but results are often quite variable with high, often ...

Acute Brain Trauma in Mice Followed By Longitudinal Two-photon Imaging

Although acute brain trauma often results from head damage in different accidents and affects a substantial fraction of the population, there is no effective treatment for it yet. Limitations of currently used animal models impede understanding of the pathology mechanism. Multiphoton microscopy allows studying cells and tissues within intact animal brains longitudinally under physiological and pathological conditions. Here, we describe two models of acute brain injury studied by means of two-photon imaging of brain cell behavior under posttraumatic conditions. A selected brain region is injured with a sharp needle to produce a trauma of a controlled width and depth in the brain parenchyma. Our method uses stereotaxic prick with a syringe needle, which can be combined with simultaneous drug application. We propose that this method can be used as an advanced tool to study cellular mechanisms of pathophysiological consequences of acute trauma in mammalian brain in vivo. In this video, we combine acute brain injury with two preparations: cranial window and skull thinning. We also discuss advantages and limitations of both preparations for multisession imaging of brain regeneration after trauma.

Acute brain trauma is a severe injury that has no adequate treatment to date. Multiphoton microscopy allows studying longitudinally the process of acute brain trauma development and probing therapeutical strategies in rodents. Two models of acute brain trauma studied with in vivo two-photon imaging of brain are demonstrated in this protocol.

Aguda Cérebro Trauma em camundongos seguiu por Longitudinal dois fótons de imagem

Although acute brain trauma often results from head damage in different accidents and affects a substantial fraction of the population, there is no ...

The bm12 Inducible Model of Systemic Lupus Erythematosus (SLE) in C57BL/6 Mice

Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical and immunological manifestations. Several spontaneous and inducible animal models mirror common components of human disease, including the bm12 transfer model. Upon transfer of bm12 splenocytes or purified CD4 T cells, C57BL/6 mice rapidly develop large frequencies of T follicular helper cells (Tfh), germinal center (GC) B cells, and plasma cells followed by high levels of circulating anti-nuclear antibodies. Since this model utilizes mice on a pure C57BL/6 background, researchers can quickly and easily study disease progression in transgenic or knockout mouse strains in a relatively short period of time. Here we describe protocols for the induction of the model and the quantitation Tfh, GC B cells, and plasma cells by multi-color flow cytometry. Importantly, these protocols can also be used to characterize disease in most mouse models of SLE and identify Tfh, GC B cells, and plasma cells in other disease models.

The bm12 Inducible Model of Systemic Lupus Erythematosus SLE in C57BL/6 Mice

The transfer of bm12 lymphocytes into a C57BL/6 recipient is an established model of systemic lupus erythematosus. Here we describe how to initiate disease using this model and how to characterize T follicular helper cells, germinal center B cells and plasma cells by flow cytometry.

O Inducible Modelo BM12 de Lúpus Eritematoso Sistêmico (LES) em camundongos C57BL / 6

Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical and immunological manifestations. Several spontaneous and inducible ...

Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

Diversion colitis (DC) is a frequent clinical condition occurring in patients with bowel segments excluded from the fecal stream as a result of a diverting enterostomy. The etiology of this disease remains ill-defined but appears to differ from that of classical inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. Research aimed to decipher the pathophysiological mechanisms leading to the development of this disease has been severely hampered by the lack of an appropriate murine model. This protocol generates a murine model of DC that facilitates the study of the immune system's role and its interaction with the microbiome in the development of DC. In this model using C57BL/6 animals, distal parts of the colon are excluded from the fecal stream by creating a distal colostomy, triggering the development of mild to moderate inflammation in the excluded bowel segments and reproducing the hallmark lesions of human DC with a moderate systemic inflammatory response. In contrast to the rat model, a large number of genetically-modified murine models on the C57BL/6 background are available. The combination of these animals with our model allows the potential roles of individual cytokines, chemokines, or receptors of bioactive molecules (e.g., interleukin (IL)-17; IL-10, chemokine CXCL13, chemokine receptors CXCR5 and CCR7, and the sphingosine-1-phosphate receptor 4) to be assessed in the pathogenesis of DC. The availability of congenic mouse strains on the C57BL/6 background largely facilitates transfer experiments to establish the roles of distinct cell types involved in the etiology of DC. Finally, the model offers the opportunity to assess the influences of local interventions (e.g., modification of the local microbiome or local anti-inflammatory therapy) on mucosal immunity in affected and non-affected bowel segments and the on systemic immune homeostasis.

Murine distal colostomy provides a murine model for human diversion colitis, a predominantly lymphocytic colitis in colon segment excluded from the fecal stream.

Murino colostomia Distal, um novo modelo de colite de diversão em camundongos C57BL/6

Diversion colitis (DC) is a frequent clinical condition occurring in patients with bowel segments excluded from the fecal stream as a result of a ...

Real-time Pressure-volume Analysis of Acute Myocardial Infarction in Mice

Acute myocardial infarction can lead to acute heart failure and cardiogenic shock. The evaluation of hemodynamics is critical for the evaluation of any potential therapeutic approach directed against acute left ventricular (LV) dysfunction. Current imaging modalities (e.g., echocardiography and magnetic resonance imaging) have several limitations since data on LV pressure cannot directly be measured. LV catheterization in mice undergoing coronary artery occlusion could serve as a novel method for a real-time evaluation of LV function.
At the beginning of the procedure, mice were anesthetized followed by endotracheal intubation. For LV catheterization, the right carotid artery was exposed via middle-neck incision. The catheter was introduced and placed into the LV cavity. Left thoracotomy was conducted and the left main coronary artery (LCA) was ligated. To induce reperfusion, the suture was released after 45 min. Pressure-volume data was recorded at all times.
Ligation of the LCA caused a decrease in LV systolic function as evidenced by a 30% reduction in stroke volume, LV ejection fraction (EF), and cardiac output. Maximum dP/dt as a parameter for LV contractility was also significantly reduced and diastolic function was severely impaired (minimum dP/dt -40%). Reperfusion over a period of 20 min did not lead to a complete recovery of LV function.
Real-time pressure-volume analysis served as a valid procedure for monitoring cardiac function during acute myocardial infarction in mice. Maintaining stable anesthesia and a standardized surgical approach was crucial to ensure valid results. As the early phase of acute myocardial infarction is critical for morbidity and mortality, the delineated method could be beneficial for preclinical evaluation of new strategies for cardioprotection.

Acute myocardial infarction in mice induces acute but incompletely characterized changes in left ventricular (LV) function. LV catheterization in mice undergoing coronary artery occlusion serves as a novel method for a real-time evaluation of LV function.

Análise em tempo real de pressão-volume de infarto agudo do miocárdio em ratos

Acute myocardial infarction can lead to acute heart failure and cardiogenic shock. The evaluation of hemodynamics is critical for the evaluation of any ...

Inducing Acute Lung Injury in Mice by Direct Intratracheal Lipopolysaccharide Instillation

Airway administration of lipopolysaccharide (LPS) is a common way to study pulmonary inflammation and acute lung injury (ALI) in small animal models. Various approaches have been described, such as the inhalation of aerosolized LPS as well as nasal or intratracheal instillation. The presented protocol describes a detailed step-by-step procedure to induce ALI in mice by direct intratracheal LPS instillation and perform FACS analysis of blood samples, bronchoalveolar lavage (BAL) fluid, and lung tissue. After intraperitoneal sedation, the trachea is exposed and LPS is administered via a 22 G venous catheter. A robust and reproducible inflammatory reaction with leukocyte invasion, upregulation of proinflammatory cytokines, and disruption of the alveolo-capillary barrier is induced within hours to days, depending on the LPS dosage used. Collection of blood samples, BAL fluid, and lung harvesting, as well as the processing for FACS analysis, are described in detail in the protocol. Although the use of the sterile LPS is not suitable to study pharmacologic interventions in infectious diseases, the described approach offers minimal invasiveness, simple handling, and good reproducibility to answer mechanistic immunological questions. Furthermore, dose titration as well as the use of alternative LPS preparations or mouse strains allow modulation of the clinical effects, which can exhibit different degrees of ALI severity or early vs. late onset of disease symptoms.

Presented here is a step-by-step procedure to induce acute lung injury in mice by direct intratracheal lipopolysaccharide instillation and to perform FACS analysis of blood samples, bronchoalveolar lavage fluid, and lung tissue. Minimal invasiveness, simple handling, good reproducibility, and titration of disease severity are advantages of this approach.

Induzindo lesão pulmonar aguda em camundongos por instilação de lipopolissacárido intratraqueal direto

Airway administration of lipopolysaccharide (LPS) is a common way to study pulmonary inflammation and acute lung injury (ALI) in small animal models. ...

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish

Cisplatin is commonly used as chemotherapy. Although it has positive effects in cancer-treated individuals, cisplatin can easily accumulate in the kidney due to its low molecular weight. Such accumulation causes the death of tubular cells and can induce the development of Acute Kidney Injury (AKI), which is characterized by a quick decrease in kidney function, tissue damage, and immune cells infiltration. If administered in specific doses cisplatin can be a useful tool as an AKI inducer in animal models. The zebrafish has appeared as an interesting model to study renal function, kidney regeneration, and injury, as renal structures conserve functional similarities with mammals. Adult zebrafish injected with cisplatin shows decreased survival, kidney cell death, and increased inflammation markers after 24 h post-injection (hpi). In this model, immune cells infiltration and cell death can be assessed by flow cytometry and TUNEL assay. This protocol describes the procedures to induce AKI in adult zebrafish by intraperitoneal cisplatin injection and subsequently demonstrates how to collect the renal tissue for flow cytometry processing and cell death TUNEL assay. These techniques will be useful to understand the effects of cisplatin as a nephrotoxic agent and will contribute to the expansion of AKI models in adult zebrafish. This model can also be used to study kidney regeneration, in the search for compounds that treat or prevent kidney damage and to study inflammation in AKI. Moreover, the methods used in this protocol will improve the characterization of tissue damage and inflammation, which are therapeutic targets in kidney-associated comorbidities.

This protocol describes the procedures to induce Acute Kidney Injury (AKI) in adult zebrafish using cisplatin as a nephrotoxic agent. We detailed the steps to evaluate the reproducibility of the technique and two techniques to analyze inflammation and cell death in the renal tissue, flow cytometry and TUNEL, respectively.

Modelo de lesão renal aguda induzida por cisplatina em zebrafish adulto

Cisplatin is commonly used as chemotherapy. Although it has positive effects in cancer-treated individuals, cisplatin can easily accumulate in the kidney ...

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, chemo- and radiation-therapies, as well as ovarian surgeries. In unmarried women with severe ovarian dysfunction, fertility preservation is important for future pregnancies. Although oocyte cryopreservation is an established method for fertility preservation, these patients could only preserve a limited number of oocytes even after ovarian hyperstimulation, leading to repeated stimulations to ensure sufficient oocytes to guarantee future pregnancy. To solve this issue, we have recently developed a drug-free in vitro activation (IVA) procedure, which enable us to stimulate early stages of ovarian follicles to develop to the preantral follicle stage. These preantral follicles can respond to the unique protocol of gonadotropin stimulation, resulting in increased number of retrieved oocytes per ovarian stimulation for cryopreservation. The drug-free IVA comprised from the surgical approach and ovarian stimulation. We removed a part of cortex from one or both ovaries from patients under laparoscopic surgery. The ovarian cortical tissues were cut into small cubes to disrupt the Hippo signaling pathway and stimulate the development of early stage follicles. These cubes were grafted orthotropically into remaining ovaries as well as beneath the serosa of both Fallopian tubes. We have already published the surgical procedure of the drug-free IVA and the protocol of subsequent ovarian stimulation, but herein we present the details of laboratory methods required for drug-free IVA.

We present details of laboratory procedures for drug-free in vitro activation (IVA) of ovarian follicles for patients with severe ovarian dysfunction. This method could increase the number of retrievable oocytes per ovarian hyperstimulation and benefit fertility preservation for those patients.

Preservação da fertilidade em pacientes com disfunção ovariana grave

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, ...