title: Epidermal growth factor serum levels and the 61 G/A polymorphism in patients with acute pancreatitis.
abstract: BACKGROUND
  Epidermal growth factor (EGF) binds to pancreatic acinar cells and facilitates recovery from acute pancreatitis (AP). In animal models, EGF protects against pancreatic injury and prevents septic complications. The role of EGF in human AP is unknown.
  
  
  OBJECTIVE
  The aim of this study was to assess EGF serum levels in AP patients and whether the EGF +61 G/A single nucleotide polymorphism (SNP) affects susceptibility and/or severity of AP.
  
  
  METHODS
  Hospitalized AP patients were prospectively enrolled. Demographics, clinical features, DNA and early serum samples were collected when available. Patients were classified into mild (79%) and severe AP (21%) based on organ failure for >or=48 h. Early serum samples were quantitatively assayed for EGF levels. The EGF +61 G/A SNP was evaluated by restriction fragment length polymorphism analysis.
  
  
  RESULTS
  There were 179 patients ascertained with AP. EGF levels were measured in a subgroup of 60 patients with early serum samples (17 severe) and in serum from 58 healthy controls. Serum EGF levels within 48 h from the onset of pain were significantly lower in AP patients (mean 13.5 pg/ml) compared to controls (25.2 pg/ml; P=0.015). Furthermore, EGF levels were significantly lower in severe patients when compared to mild (7.8 vs. 14.3 pg/ml; P=0.026). DNA from all 179 patients and 189 healthy controls was sequenced. The EGF +61 G/A SNP did not affect susceptibility to or severity of AP.
  
  
  CONCLUSIONS
  EGF serum levels are decreased early in the course of AP and are further suppressed in severe AP. The EGF +61 G/A polymorphism has no effect on AP.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Presbyterian, M2 C Wing, 200 Lothrop Street, Pittsburgh, PA 15213, USA. papachri@pitt.edu
authors.forename: Georgios I
authors.initials: GI
authors.lastname: Papachristou
authors.forename: Venkata
authors.initials: V
authors.lastname: Muddana
authors.forename: Dionysios J
authors.initials: DJ
authors.lastname: Papachristou
authors.forename: Kim
authors.initials: K
authors.lastname: Stello
authors.forename: David C
authors.initials: DC
authors.lastname: Whitcomb
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015536:Down-Regulation; D004815:Epidermal Growth Factor / Q000097:blood* / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000097:blood* / Q000235:genetics*; D010414:Pennsylvania; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004815:Epidermal Growth Factor