Effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 in patients with post-ERCP pancreatitis

Objective To investigate the effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 ( NAG-1) in patients with post-ERCP pancreatitis ( PEP) . Methods A total of 120 patients who underwent ERCP in The First Affiliated Hospital of Anhui Medical University from September 2012 to October 2013 were enrolled and randomly divided into diclofenac sodium group and control group, with 60 patients in each group. The patients in the diclofenac sodium group were given intramuscular injection of Olfen ( containing diclofenac sodium 75 mg) immediately after ERCP. Blood samples were collected before surgery and at 3 and 24 hours after surgery, and the level of amylase was measured. The incidence of abdominal pain was also observed and the incidence rate of PEP was calculated for both groups. RT-PCR and Western blot were used to measure the mRNA and protein expression of NAG-1 in plasma. An repeated-measures analysis of variance was used for comparison of continuous data; a univariate analysis of variance was used for data meeting the requirements of sphericity test, and the Greenhouse-Geisser correction method was used for data which did not meet the requirements of sphericity test. The chi-square test was used for comparison of categorical data between groups. Results The diclofenac sodium group had a significantly lower incidence rate of PEP than the control group [6. 67% ( 4/60) vs 20. 00% ( 12/60) , χ2= 4. 62, P = 0. 03].The diclofenac sodium group had a significantly lower level of amylase than the control group at 3 and 24 hours after surgery ( at 3 hours after surgery: 202. 70 ± 120. 44 U/L vs 283. 57 ± 178. 39 U/L, t = 2. 06, P < 0. 05; at 24 hours after surgery: 209. 13 ± 157. 14 U/L vs 305. 97 ±208. 69 U/L, t = 2. 03, P < 0. 05) . At 3 hours after ERCP, the diclofenac sodium group had significant increases in the mRNA and protein expression of NAG-1 in plasma and significantly higher mRNA and protein expression of NAG-1 than the control group ( all P < 0. 01) .Conclusion Diclofenac sodium can prevent PEP, possibly by promoting the level of NAG-1.