Probing the urinary proteome of severe acute pancreatitis.
BACKGROUND
Proteinuria is a characteristic feature of severe acute pancreatitis (SAP) that may allow unique insights into AP pathophysiology. This study used a proteomic approach to differentiate the abundant urinary proteins in AP patients.


METHODS
Urine samples were prospectively collected from 4 groups (5 SAP, 10 mild gallstone AP, 7 mild alcohol AP, 7 controls). Reverse-phase high-performance liquid chromatography (RP-HPLC) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (LC MALDI) were used to identify urinary proteins and determine any differences between the groups.


RESULTS
There were 17 RP-HPLC major peaks in SAP groups of significantly greater absorbance magnitude than the corresponding ones in mild and control groups. Various mass spectrometry methods were used to identify 21 different parent proteins from these SAP peaks. They included fibrinogen, serum amyloid A, insulin and calcitonin gene-related peptides. There were no identifiable protein peaks at the corresponding elution times in the mild pancreatitis and controls samples.


CONCLUSIONS
Proteomic techniques offer a unique unexplored window into AP pathophysiology. The utility of these proteins as markers of pancreatitis severity now need to be further investigated and the identification extended to the full urinary proteome as technology permits.
Flint
Richard S
RS
Department of Surgery, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.
Phillips
Anthony R J
AR
Farrant
Glenn J
GJ
McKay
Duncan
D
Buchanan
Christina M
CM
Cooper
Garth S J
GS
Windsor
John A
JA