title: [Influence of continuous high-volume hemofiltration on IRAK-4 protein expression in severe acute pancreatitis].
abstract: OBJECTIVE
  To investigate the influence of continuous high-volume hemofiltration (CHVHF) on interleukin 1 receptor-associated kinase-4 (IRAK-4) and tumor necrosis factor-alpha (TNF-alpha) levels in patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  Forty-one patients with SAP were randomly divided into two groups to receive treatment with CHVHF plus conventional therapy (21 patients) and conventional therapy only (20 patients). Venous blood samples were taken before and 12, 24, and 72 h after the treatment for evaluation of APACHE II scores. The mRNA and protein levels of IRAK-4 in the monocytes were determined by real-time PCR and Western blotting, respectively, and serum TNF-alpha levels was detected using enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  Among the 21 patients receiving CHVHF, 18 survived and 3 died, and in the conventional therapy group, death occurred in 5 cases. In the surviving patients of CHVHF group, the APACHE II scores, IRAK-4 mRNA and protein levels and TNF-alpha levels were all significantly lowered after the treatment, and these indices were also significantly lower than those in the conventional group after treatment (P<0.05).
  
  
  CONCLUSIONS
  CHVHF is effective in reducing monocyte IRAK-4 levels and serum TNF-alpha level in SPA patients, and thus alleviates the symptoms and improves the prognosis of SAP, possibly by reducing the level of the activators that induce monocyte activation via the Toll-like receptor.
authors.affiliation: Department of Hepatobiliary Surgery, Second Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing 400010, China.
authors.forename: Chun-Mu
authors.initials: CM
authors.lastname: Miao
authors.forename: Guang-Quan
authors.initials: GQ
authors.lastname: Zhang
authors.forename: Zuo-Jin
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Gong
mesh_terms: D000328:Adult; D015153:Blotting, Western; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D053592:Interleukin-1 Receptor-Associated Kinases / Q000097:blood* / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; C507773:IRAK4 protein, human; D053592:Interleukin-1 Receptor-Associated Kinases