Results of treating severe acute pancreatitis with gabexate is associated with neutrophil apoptosis activity.
OBJECTIVE
A delay in polymorphonuclear neutrophil apoptosis has been implicated in the pathogenesis of systemic inflammatory reactions in certain conditions. Gabexate mesilate has been proven effective in the treatment of severe acute pancreatitis with organ dysfunction. In this study, we attempted to answer the questions of whether neutrophil apoptosis is associated with the conditions of various major organs in patients with severe acute pancreatitis and receiving gabexate.


METHODS
A total of 45 patients were included in this study. We divide the patients into two groups. Group A included patients with > or = 2 complications after one-week treatment (n = 31), and Group B included patients with < 2 complications after one-week treatment (n = 14). Serum interleukin-6 and interleukin-8 was detected at day 1, 3, and 7 of treatment using enzyme-linked immunosorbent assay kits. The neutrophil CD18 expression and apoptosis activity were evaluated flowcytometrically at day 1, 3, and 7 of treatment.


RESULTS
At day 7 of treatment, interleukin-6 levels were significantly higher in Group B while interleukin-8 levels were not different. The neutrophil CD18 expression was significantly higher and delayed ex vivo apoptosis was significantly lower in the group B than that of group A at day 7 of treatment.


CONCLUSIONS
In patients of severe acute pancreatitis with organ dysfunction and receiving gabexate treatment, neutrophil apoptosis is associated with the severity of organ dysfunction.
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
De-Fa
DF
Chiu
Jih-Chang
JC
Chen
Han-Ming
HM
Chen
Chip-Jin
CJ
Ng
Ming-Hwang
MH
Shyr
Miin-Fu
MF
Chen
D017209:Apoptosis; D016207:Cytokines / Q000097:blood; D005260:Female; D016670:Gabexate / Q000627:therapeutic use*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D010195:Pancreatitis / Q000188:drug therapy* / Q000503:physiopathology; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*
D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D015842:Serine Proteinase Inhibitors; D016670:Gabexate