title: Adipokines and cytokines in human pancreatic juice: unraveling the local pancreatic inflammatory milieu.
abstract: BACKGROUND
  Differential adipokine expression in obesity influences the inflammatory milieu, and may explain in part obesity's negative impact on pancreatic disease. Pancreatic juice analysis may provide a good means to evaluate the local pancreatic inflammatory milieu. The presence of adipokines in pancreatic juice is unknown.
  
  
  OBJECTIVE
  This proof-of-concept study was designed to determine the presence of adipokines and cytokines in human pancreatic juice.
  
  
  METHODS
  With institutional review board approval, pancreatic juice was obtained from ten patients with a broad range of diagnoses at the time of endoscopic retrograde cholangiopancreatography. Pancreatic juice was assayed using enzyme-linked immunosorbent assay (ELISA) for insulin, the proinflammatory adipokine leptin, the anti-inflammatory adipokine adiponectin, and the inflammatory mediators interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and monocyte chemoattractant protein-1 (MCP-1). Correlation between adipokine and inflammatory mediator expression was determined by linear regression analysis. Data are presented as mean +/- standard error of the mean (SEM); P < 0.05 was considered statistically significant.
  
  
  RESULTS
  Leptin (0.16 +/- 0.05 ng/ml) and adiponectin (0.63 +/- 0.02 microg/ml) were both present, as were the inflammatory mediators IL-6 (112.6 +/- 28.1 pg/ml), TNF-alpha (49.0 +/- 18.8 pg/ml), and MCP-1 (32.2 +/- 0.9 pg/ml). Paradoxically, the expression of the anti-inflammatory adipokine adiponectin correlated strongly with that of the proinflammatory cytokine IL-6 (R(2) = 0.98, P < 0.001).
  
  
  CONCLUSIONS
  This report is the first to describe adipokine expression in human pancreatic juice. Human pancreatic juice inflammatory mediators and adipokines may provide an important measurement of the local pancreatic inflammatory milieu.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indiana University, Indianapolis, IN 46202, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Dalbec
authors.forename: C
authors.initials: C
authors.lastname: Max Schmidt
authors.forename: Terence E
authors.initials: TE
authors.lastname: Wade
authors.forename: Sue
authors.initials: S
authors.lastname: Wang
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Swartz-Basile
authors.forename: Henry A
authors.initials: HA
authors.lastname: Pitt
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Zyromski
mesh_terms: D054392:Adipokines / Q000032:analysis / Q000378:metabolism*; D052242:Adiponectin / Q000032:analysis / Q000378:metabolism; D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis / Q000378:metabolism*; D007328:Insulin / Q000032:analysis / Q000378:metabolism; D020738:Leptin / Q000032:analysis / Q000378:metabolism; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010186:Pancreatic Function Tests; D010189:Pancreatic Juice / Q000737:chemistry*; D010195:Pancreatitis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index
chemical_list: D054392:Adipokines; D052242:Adiponectin; D016207:Cytokines; D018836:Inflammation Mediators; D007328:Insulin; D020738:Leptin