Monocytes in systematic inflammatory response syndrome: differences between sepsis and acute pancreatitis.
OBJECTIVE
To unravel the differences between systematic inflammatory response syndrome (SIRS) of acute pancreatitis compared to the same syndrome in sepsis.


METHODS
Twenty-five patients were enrolled, 12 with sepsis and 13 acute pancreatitis. After diagnosis 20 mL blood was sampled. Half were assayed for isolation of monocytes and 10 mL was centrifuged for serum test of tumor necrosis factor alpha (TNFalpha and interleukin-6 (IL-6). Half of monocytes were incubated in the presence of patients' serum and supernatants were collected. The other half was treated for estimation of optical photometry under caspase-3 inhibition. TNFalpha and IL-6 were estimated by an enzyme immunoassay.


RESULTS
median+/-SE of serum IL-6 in septic patients and acute pancreatitis patients was 192.30+/-35.40 ng/L and 21.00+/-16.05 ng/L, respectively (P<0.01). Respective values of caspase-3 were 0.94+/-0.17 pmol/min 10(4) cells and 0.34+/-0.09 pmol/min 10(4) cells (P<0.05). IL-6 of monocyte supernatants of patients with sepsis was significantly increased after addition of patients' serum, while that of patients with acute pancreatitis did not show significant difference.


CONCLUSIONS
The data have shown that monocyte activity is different between acute pancreatitis and sepsis. This phenomenon might be explained as a different pathway to the pro-inflammatory cytokines release or could be a novel anti-inflammatory response in acute pancreatitis.
Koussoulas
Vassilios
V
Department of Internal Medicine, University of Athens, Medical School, and Attikon University Hospital, 1 Rimini Str., Athens 124 62, Greece.
Tzivras
Michalis
M
Karagianni
Vassiliki
V
Spyridaki
Ekaterini
E
Plachouras
Diamantis
D
Giamarellou
Helen
H
Giamarellos-Bourboulis
Evangelos J
EJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D053148:Caspase 3 / Q000097:blood; D003937:Diagnosis, Differential; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism / Q000473:pathology*; D010195:Pancreatitis / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D053148:Caspase 3