Serum interleukin-6 and interleukin-10 in patients with acute pancreatitis: clinical implications.
OBJECTIVE
Cytokines are assumed to play an important role in the pathogenesis of acute pancreatitis, but little is actually known. In this study, we assessed changes in the serum levels of interleukin-6 (IL-6), a proinflammatory cytokine, and interleukin-10 (IL-10), an anti-inflammatory cytokine, in patients with acute pancreatitis.


METHODS
Serum levels of IL-6 and IL-10 were measured in 47 patients with acute pancreatitis and compared with their clinical and laboratory data. Changes of the serum levels of the two cytokines were studied in relation to the severity of acute pancreatitis. In addition, the changes of these cytokines after treatment of severe acute pancreatitis were assessed.


RESULTS
1) The serum IL-6 level showed a significant correlation with markers of the severity of acute pancreatitis, suggesting that IL-6 was a useful indicator of the severity of this disease. 2) The IL-10/IL-6 ratio was significantly lower in patients with severe acute pancreatitis, suggesting that a proinflammatory response was predominant in these patients. 3) The IL-10/IL-6 ratio of the patients with severe acute pancreatitis was significantly increased after treatment, especially in patients who received continuous regional arterial infusion of a protease inhibitor and antibiotics.


CONCLUSIONS
The predominant pathological state of patients with severe acute pancreatitis may be altered from the systemic inflammatory response syndrome to the compensatory anti-inflammatory response syndrome by successful treatment.
Division of Hepatology, Department of Medicine, Kawasaki Medical School, Kurashiki, Japan. ohmotok@med.kawasaki-m.ac.jp
Kenji
K
Ohmoto
Shinichiro
S
Yamamoto
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000150:complications / Q000628:therapy; D011480:Protease Inhibitors / Q000627:therapeutic use; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology / Q000628:therapy
D000900:Anti-Bacterial Agents; D015850:Interleukin-6; D011480:Protease Inhibitors; D016753:Interleukin-10; D002097:C-Reactive Protein