title: Monocyte chemoattractant protein 1, active carboxypeptidase B and CAPAP at hospital admission are predictive markers for severe acute pancreatitis.
abstract: BACKGROUND
  CAPAP, the activation peptide of procarboxypeptidase B, is a predictor of severe acute pancreatitis (AP). Active carboxypeptidase (aCAP) may be a better predictor, as its turnover is slower. Monocyte chemotactic protein-1 (MCP-1) is an early inflammatory marker and increases before complications in severe AP. We conducted a cohort study to evaluate these markers as predictors for severe AP.
  
  
  METHODS
  140 patients with AP were included, retrospectively grouped as severe or mild by the Atlanta classification. CAPAP, MCP-1 and aCAP were analyzed in admission samples. Receiver operating characteristic curves determined high vs. low levels.
  
  
  RESULTS
  The levels of all markers were significantly higher in patients with severe disease. High levels of serum MCP-1 was associated with a high risk of developing severe AP (OR 40.8; 95% CI 8.5-195). High ORs were also seen for urine MCP-1 (OR 7.3; 95% CI 2.2-24.3), serum CAPAP (OR 5.4; 95% CI 1.6-17.7), urine CAPAP (OR 4.8; 95% CI 1.6-14.2), and serum aCAP (OR 3.7; 95% CI 1.2-11.3).
  
  
  CONCLUSIONS
  Serum MCP-1 at admission was strongly associated with development of severe AP. MCP-1 in urine, CAPAP in serum and urine and aCAP may also be useful for predicting severe AP. and IAP.
authors.affiliation: Department of Surgery, Malmo University Hospital, Lund University, Lund, Sweden. sara.regner@med.lu.se
authors.forename: S
authors.initials: S
authors.lastname: Regnér
authors.forename: S
authors.initials: S
authors.lastname: Appelros
authors.forename: C
authors.initials: C
authors.lastname: Hjalmarsson
authors.forename: J
authors.initials: J
authors.lastname: Manjer
authors.forename: J
authors.initials: J
authors.lastname: Sadic
authors.forename: A
authors.initials: A
authors.lastname: Borgstrom
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D043424:Carboxypeptidase B / Q000097:blood*; D018932:Chemokine CCL2 / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood*; D010455:Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D010455:Peptides; C110925:carboxypeptidase B activation peptide; D043424:Carboxypeptidase B