title: Interleukin 1 receptor antagonist and E-selectin concentrations: a comparison in patients with severe acute pancreatitis and severe sepsis.
abstract: OBJECTIVE
  This prospective clinical study was designed to compare interleukin 1 receptor antagonist (IL-1ra) and E-selectin concentrations in patients with severe acute pancreatitis to those with severe sepsis.
  
  
  METHODS
  Nine consecutive patients with severe acute pancreatitis and 11 consecutive patients with severe sepsis admitted to a medical/surgical intensive care unit were included in the study. Plasma concentrations of IL-1ra and E-selectin were serially measured daily for 7 days or throughout their stay in the intensive care unit if shorter.
  
  
  RESULTS
  The concentrations of IL-1ra were significantly higher on admission in patients with severe sepsis compared with the patients with severe pancreatitis (median levels 10,500 and 2,600 pg/mL, respectively, P = .007). When the data from the first 3 days were analyzed using analysis of variance (ANOVA), the levels of IL-1ra and E-selectin were similar in both groups. The concentrations of IL-1ra and E-selectin correlated to the development of multiorgan dysfunction as assessed by sequential organ failure assessment (SOFA) score (P = .032 and .043, respectively).
  
  
  CONCLUSIONS
  This study shows that IL-1ra and E-selectin are released in acute severe pancreatitis, and the levels seem to be comparable to those in patients with severe sepsis. Concentrations of IL-1ra and E-selectin correlate to the development of multiorgan failure as indicated by high SOFA scores during the first week of disease.
authors.affiliation: Department of Surgery, Helsinki University Hospital, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Hynninen
authors.forename: M
authors.initials: M
authors.lastname: Valtonen
authors.forename: H
authors.initials: H
authors.lastname: Markkanen
authors.forename: M
authors.initials: M
authors.lastname: Vaara
authors.forename: P
authors.initials: P
authors.lastname: Kuusela
authors.forename: I
authors.initials: I
authors.lastname: Jousela
authors.forename: A
authors.initials: A
authors.lastname: Piilonen
authors.forename: O
authors.initials: O
authors.lastname: Takkunen
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010195:Pancreatitis / Q000097:blood* / Q000150:complications / Q000276:immunology* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000276:immunology* / Q000401:mortality; D012720:Severity of Illness Index; D012795:Sialoglycoproteins / Q000097:blood*; D013997:Time Factors
chemical_list: D019040:E-Selectin; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D012795:Sialoglycoproteins