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Different profiles of cytokine expression during mild and severe acute pancreatitis

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Author(s): Zilvinas Dambrauskas, Nathalia Giese, Antanas Gulbinas, Thomas Giese, Pascal O Berberat, Juozas Pundzius, Giedrius Barauskas; Helmut Friess

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 16;
Issue: 15;
Start page: 1845;
Date: 2010;
Original page

Keywords: Acute pancreatitis | Cytokines | Prognostic factors

ABSTRACT
AIM: To study secretion patterns of pro- and anti-inflammatory cytokines, and activation of various cellular subsets of leukocytes in peripheral blood.METHODS: We have conducted a prospective observational study. One hundred and eight patients with a diagnosis of acute pancreatitis and onset of the disease within last 72 h were included in this study. The mRNA expression of 25 different types of cytokines in white blood cells was determined by quantitative real time polymerase chain reaction. Levels of 8 different cytokines in blood serum were measured by enzyme linked immunosorbent assay. Clinical data and cytokine expression results were subjected to statistical analysis.RESULTS: Severe and necrotizing acute pancreatitis (AP) is characterized by the significant depletion of circulating lymphocytes. Severe acute pancreatitis is associated with a typical systemic inflammatory response syndrome and over-expression of pro-inflammatory cytokines [interleukin (IL)-6, IL-8, macrophage migration inhibitory factor (MIF)]. Serum IL-6 and MIF concentrations are the best discriminators of severe and necrotizing AP as well as possible fatal outcome during the early course of the disease.CONCLUSION: Deregulation of cellular immune system is a key event leading to severe and necrotizing AP. IL-6 and MIF could be used as early predictors of complications.
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