Levels of the chemokines growth-related oncogene alpha and epithelial neutrophil-activating protein 78 are raised in patients with severe acute pancreatitis.
BACKGROUND
Multiple organ dysfunction syndrome secondary to systemic leucocyte activation is the major cause of death following an attack of acute pancreatitis. Although plasma levels of interleukin (IL) 8 are known to be raised in acute pancreatitis, levels of other CXC chemokines such as growth-related oncogene (GRO) alpha and epithelial neutrophil-activating protein (ENA) 78, which are also potent neutrophil chemoattractants and activators, have not been measured.


METHODS
Timed plasma samples were obtained from 51 patients with acute pancreatitis, 27 with a severe attack and 24 with mild disease according to the Atlanta classification. Samples were analysed to determine levels of C-reactive protein (CRP), IL-8, GRO-alpha and ENA-78.


RESULTS
Plasma levels of IL-8, GRO-alpha and ENA-78 were increased in patients with severe as opposed to mild acute pancreatitis as early as 24 h following disease onset. Using cut-off levels of 7 pg/ml for IL-8, 70 pg/ml for GRO-alpha and 930 pg/ml for ENA-78, peak levels within the first 24 h of admission had an accuracy of 81, 71 and 87 per cent respectively in predicting the severity of an attack of acute pancreatitis.


CONCLUSIONS
In patients with severe acute pancreatitis plasma levels of GRO-alpha and ENA-78 were raised in addition to those of IL-8, suggesting that all three chemokines are involved in the inflammatory response in this condition.
Shokuhi
S
S
Departments of Surgery and Immunology, University of Liverpool, 5th floor University Clinical Departments Building, Daulby Street, Liverpool L69 3GA, UK.
Bhatia
M
M
Christmas
S
S
Sutton
R
R
Neoptolemos
J P
JP
Slavin
J
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D054365:Chemokine CXCL5; D018925:Chemokines / Q000378:metabolism*; D019743:Chemokines, CXC; D005260:Female; D006133:Growth Substances / Q000378:metabolism; D006801:Humans; D016209:Interleukin-8 / Q000031:analogs & derivatives* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation / Q000502:physiology; D009857:Oncogenes; D010195:Pancreatitis / Q000378:metabolism* / Q000473:pathology
C486263:CXCL5 protein, human; D054365:Chemokine CXCL5; D018925:Chemokines; D019743:Chemokines, CXC; D006133:Growth Substances; D016209:Interleukin-8; D002097:C-Reactive Protein