Serum interleukin-15 level is a useful predictor of the complications and mortality in severe acute pancreatitis.
BACKGROUND
In severe acute pancreatitis, multiple organ dysfunction syndrome and infectious complications are contributors to high mortality. Interleukin (IL)-15 is a novel cytokine that shares many biologic properties with IL-2. Serum IL-15 levels have not yet been determined in SAP.


METHODS
Serum IL-15 concentrations were measured in 54 patients with severe acute pancreatitis on admission. The relationships with severity, organ dysfunction, infection, and prognosis were analyzed. Utility of IL-15 for the prediction of clinical outcome was evaluated by receiver operator characteristic (ROC) curve analysis.


RESULTS
Serum IL-15 levels were increased significantly in severe acute pancreatitis (5.8 +/- 0.5 pg/mL), and they were correlated with Ranson, APACHE II, and Japanese severity score. Serum IL-15 levels were greater in patients with organ dysfunction, patients with infection, and nonsurvivors (P < 05 each). Incidences of organ dysfunction in patients whose IL-15 levels were less than 3.0, 3.0-5.3, and greater than or equal to 5.3 pg/mL, were 8%, 31%, and 89%, respectively (P < .001). Usefulness of IL-15 for the prediction of organ dysfunction was superior to CRP, IL-6, and IL-8, and it was similar to Ranson, APACHE II, and Japanese severity score. Incidences of infection in patients whose IL-15 levels were less than 5.5, 5.5-9.0, and greater than or equal to 9.0 pg/mL, were 7%, 25%, and 50%, respectively (P < .05). Mortality rates in patients whose IL-15 levels were less than 5.5, 5.5-9.0, and greater than or equal to 9.0 pg/mL, were 11%, 25%, and 80%, respectively (P < .001). Usefulness of IL-15 for the prediction of death was superior to CRP, IL-6, and IL-8.


CONCLUSIONS
Serum IL-15 level is a useful predictor of the complications (especially organ dysfunction) and mortality in severe acute pancreatitis.
Ueda
Takashi
T
Department of Gastroenterological Surgery, Kobe University Graduate School of Medical Sciences, Kobe, Japan. uedataka@med.kobe-u.ac.jp
Takeyama
Yoshifumi
Y
Yasuda
Takeo
T
Shinzeki
Makoto
M
Sawa
Hidehiro
H
Nakajima
Takahiro
T
Takase
Kozo
K
Matsumoto
Ippei
I
Fujita
Tsunenori
T
Ajiki
Tetsuo
T
Fujino
Yasuhiro
Y
Kuroda
Yoshikazu
Y
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D019409:Interleukin-15 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D009336:Necrosis / Q000097:blood; D010179:Pancreas / Q000503:physiopathology; D010195:Pancreatitis / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D012727:Sex Characteristics; D015996:Survival Rate; D013997:Time Factors
D015415:Biomarkers; D019409:Interleukin-15