Anaphylatoxin generation in acute pancreatitis.
Fifty-one patients with elevated serum amylase and clinical signs of acute pancreatitis were studied prospectively. The concentrations of anaphylatoxins (C3a and C5a) were measured with a radioimmunoassay and the activity of their inactivator was determined. The pancreatitis was classified as mild, moderate, or severe according to Ranson's 11 signs, appearance of peritoneal fluid, and development of multisystem organ failure (MSOF). Plasma C3a and C5a concentrations were elevated during attacks of acute pancreatitis. Anaphylatoxin levels correlated with the severity of the disease (C3a, P less than 0.001; C5a, P less than 0.05). The highest and most persistent levels were found in the group with MSOF. C3a levels decreased rapidly during recovery. In patients with complications like abscess or pseudocyst, the C3a elevation persisted until adequate treatment was instituted. In this study, no significant changes of the inactivator levels were found, except at discharge when the inactivator level of the severe group was elevated compared to that of the moderate and mild groups (P less than 0.05).
Roxvall
L
L
Department of Surgery, Sahlgren's Hospital, University of Gothenburg, Sweden.
Bengtson
A
A
Heideman
M
M
D000208:Acute Disease; D000706:Anaphylatoxins / Q000037:antagonists & inhibitors / Q000096:biosynthesis*; D003167:Complement Activation; D003176:Complement C3 / Q000037:antagonists & inhibitors / Q000096:biosynthesis*; D015926:Complement C3a; D003182:Complement C5 / Q000037:antagonists & inhibitors / Q000096:biosynthesis*; D015936:Complement C5a; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000276:immunology; D010195:Pancreatitis / Q000097:blood / Q000145:classification / Q000276:immunology*; D010452:Peptide Biosynthesis; D011446:Prospective Studies
D000706:Anaphylatoxins; D003176:Complement C3; D003182:Complement C5; D015926:Complement C3a; D015936:Complement C5a