title: Is the monocyte chemotactic protein-1 -2518 G allele a risk factor for severe acute pancreatitis?
abstract: OBJECTIVE
  Acute pancreatitis (AP) reflects the intensity of the inflammatory response and is divided into mild AP (MAP) or severe AP (SAP). Monocyte chemotactic protein-1 (MCP-1) gene expression is altered by an A/G polymorphism (-2518), with the G allele increasing MCP-1 production. Our aim was to determine whether the MCP-1 -2518 A/G polymorphism affects the severity of AP.
  
  
  METHODS
  Seventy-seven consecutive patients and 116 controls were evaluated. The A/G genotype was evaluated by polymerase chain reaction amplification, restriction fragment length polymorphism, and DNA sequencing. MCP-1 serum levels were quantified using a fluorescence bead-based immunoassay.
  
  
  RESULTS
  Sixty-three of 77 patients had MAP (82%) and 14 of 77 had SAP (18%). Patients with SAP had a significantly greater proportion of the G allele (12 of 14; 86%) than did control subjects (50 of 116; 43%) (odds ratio [OR], 7.9; 95% confidence interval [CI], 1.7-37, P < .003) or MAP patients (29 of 63; 46%) (OR, 7.0; 95% CI, 1.5-34; P < .007). Patients with pancreatitis and AA genotype had a low risk for SAP (OR, .13; 95% CI, .01-.61; P < .003). As predicted by the genotype, the serum MCP-1 levels were significantly higher in the SAP patients when compared with the MAP patients ( P = .002) and they also predicted death.
  
  
  CONCLUSIONS
  MCP-1 -2518 G allele is a risk factor for severe AP. MCP-1 serum levels, measured early in the course of AP, appear to be an accurate predictor of severity of acute pancreatitis and death.
authors.affiliation: Department of Medicine, University of Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Georgios I
authors.initials: GI
authors.lastname: Papachristou
authors.forename: David A
authors.initials: DA
authors.lastname: Sass
authors.forename: Haritha
authors.initials: H
authors.lastname: Avula
authors.forename: Janette
authors.initials: J
authors.lastname: Lamb
authors.forename: Anna
authors.initials: A
authors.lastname: Lokshin
authors.forename: M Michael
authors.initials: MM
authors.lastname: Barmada
authors.forename: Adam
authors.initials: A
authors.lastname: Slivka
authors.forename: David C
authors.initials: DC
authors.lastname: Whitcomb
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000235:genetics*; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D011446:Prospective Studies; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D012720:Severity of Illness Index
chemical_list: D018932:Chemokine CCL2