[Cytokines and other immunological parameters as markers of distant organ involvement in acute pancreatitis].
OBJECTIVE
There is a role of immunologic proinflammatory mediators in pathogenesis of distant organ disfunction in acute pancreatitis (AP). The aim is to evaluate the relationship between those mediators and liver, kidney and lung disfunction in patients with AP.


METHODS
On the day of admission in 34 patients with AP, biochemical parameters of liver function, creatinine and arterial partial pressure of oxygen (PO2) were determined, and cut points were established. Soluble tumor necrosis factor receptor I (sTNFRI), interleukin (IL) 1 receptor antagonist (IL-1Ra), IL-6, soluble IL-6 receptor (sIL-6R), IL-18, and intercellular adhesion molecule-1 (ICAM-1) were determined on days 1, 2, 3 and 7, and were compared between patients with biochemical parameters and PO2 on admission higher or lower than an established cut point.


RESULTS
Levels of sTNFRI, IL-18 and ICAM-1 were significantly higher and sustained, and IL-6 only the first day, in patients with parameters of liver function above the cut point. sTNFRI, IL-1Ra and ICAM-1 early showed significantly higher levels in relation with serum creatinine, and these and also IL-6 in those with PO2 below 60 mmHg.


CONCLUSIONS
sTNFRI, IL-6, IL-18 and ICAM-1 behaved as early markers of hepatic alteration, sTNFRI, IL-1Ra and ICAM-1 of renal disfunction and these and IL-6 of lung injury.
Martín Alonso
María Angeles
MA
Servicio de Aparato Digestivo, Hospital Universitario Río Hortega, Facultad de Medicina, Universidad de Valladolid, Ramón y Cajal 7, 47005 Valladolid, Spain. medicina@med.uva.es
Santamaría
Ana
A
Saracíbar
Esther
E
Arranz
Eduardo
E
Garrote
José A
JA
Almaraz
Ana
A
Caro-Patón
Agustín
A
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D003404:Creatinine / Q000097:blood; D016207:Cytokines / Q000502:physiology*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000502:physiology*; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008099:Liver / Q000503:physiopathology*; D008111:Liver Function Tests; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology*; D012129:Respiratory Function Tests; D013997:Time Factors
D015415:Biomarkers; D016207:Cytokines; D018799:Intercellular Adhesion Molecule-1; D003404:Creatinine