title: Do the changes in the serum levels of IL-2, IL-4, TNFalpha, and IL-6 reflect the inflammatory activity in the patients with post-ERCP pancreatitis?
abstract: BACKGROUND
  Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP) procedure and there are some reports showing cytokine changes in ERCP-induced pancreatits.
  
  
  OBJECTIVE
  To investigate the association between early changes (within 24 hours) in the serum interleukin (IL)-2, IL-4, tumor necrosis factor (TNF)alpha, and IL-6 levels and the development of post-ERCP pancreatitis.
  
  
  METHODS
  Forty five consecutive patients who underwent therapeutic ERCP and 10 patients with acute pancreatitis without ERCP were enrolled to the study. Serum concentrations of IL-2, IL-4, TNFalpha, and IL-6 were determined immediately before, 12 hours and 24 hours after ERCP.
  
  
  RESULTS
  Seven of the 45 patients (15.5%) developed post-ERCP pancreatitis. The levels of IL-4 at 24 hours after ERCP were significantly lower in the patients with post-ERCP pancreatitis than in those without pancreatitis, while TNFalpha levels at 12 hours after ERCP were higher in the complicated group than those of the uncomplicated group. The ratios of TNFalpha/IL-4 at 12 and 24 hours after ERCP were found significantly higher in the patients with post-ERCP pancreatitis than in those without pancreatitis. IL-6 in the complicated patients was found significantly increased at 24 hours after ERCP.
  
  
  CONCLUSIONS
  The enhancement of serum TNFalpha and IL-6 levels in the patients with ERCP-induced pancreatitis reflects the inflammatory activity. Additionally, these cytokines together with IL-4 can be used in clinical laboratory monitoring of ERCP.
authors.affiliation: Department of Gastroenterology, Gulhane Military Medical Academy, School of Medicine, Etlik, 06010 Ankara, Turkey.
authors.forename: Guldem
authors.initials: G
authors.lastname: Kilciler
authors.forename: Ugur
authors.initials: U
authors.lastname: Musabak
authors.forename: Sait
authors.initials: S
authors.lastname: Bagci
authors.forename: Zeki
authors.initials: Z
authors.lastname: Yesilova
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tuzun
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uygun
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gulsen
authors.forename: Sema
authors.initials: S
authors.lastname: Oren
authors.forename: Cagatay
authors.initials: C
authors.lastname: Oktenli
authors.forename: Necmettin
authors.initials: N
authors.lastname: Karaeren
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000209:etiology / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D007376:Interleukin-2; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4