Different profiles of cytokine expression during mild and severe acute pancreatitis.
OBJECTIVE
To study secretion patterns of pro- and anti-inflammatory cytokines, and activation of various cellular subsets of leukocytes in peripheral blood.


METHODS
We have conducted a prospective observational study. One hundred and eight patients with a diagnosis of acute pancreatitis and onset of the disease within last 72 h were included in this study. The mRNA expression of 25 different types of cytokines in white blood cells was determined by quantitative real time polymerase chain reaction. Levels of 8 different cytokines in blood serum were measured by enzyme linked immunosorbent assay. Clinical data and cytokine expression results were subjected to statistical analysis.


RESULTS
Severe and necrotizing acute pancreatitis (AP) is characterized by the significant depletion of circulating lymphocytes. Severe acute pancreatitis is associated with a typical systemic inflammatory response syndrome and over-expression of pro-inflammatory cytokines [interleukin (IL)-6, IL-8, macrophage migration inhibitory factor (MIF)]. Serum IL-6 and MIF concentrations are the best discriminators of severe and necrotizing AP as well as possible fatal outcome during the early course of the disease.


CONCLUSIONS
Deregulation of cellular immune system is a key event leading to severe and necrotizing AP. IL-6 and MIF could be used as early predictors of complications.
Dambrauskas
Zilvinas
Z
Laboratory for Research of Digestive System, Institute for Biomedical Research, Eiveniu Str. 2, 50009 Kaunas, Lithuania. zilvinas.dambrauskas@gmail.com
Giese
Nathalia
N
Gulbinas
Antanas
A
Giese
Thomas
T
Berberat
Pascal O
PO
Pundzius
Juozas
J
Barauskas
Giedrius
G
Friess
Helmut
H
D000328:Adult; D000368:Aged; D016207:Cytokines / Q000378:metabolism; D005260:Female; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D006801:Humans; D007107:Immune System; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D007962:Leukocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010195:Pancreatitis / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism
D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D012333:RNA, Messenger
Br J Surg. 1990 Nov;77(11):1260-4
2253005
Am J Surg. 1991 Jan;161(1):19-24; discussion 24-5
1987854
J Clin Gastroenterol. 2003 Apr;36(4):360-3
12642746
Br J Surg. 1989 Feb;76(2):177-81
2467718
J Clin Invest. 1997 Oct 1;100(7):1853-62
9312187
Am J Gastroenterol. 1982 Sep;77(9):633-8
7051819
Dig Dis Sci. 1995 Nov;40(11):2341-8
7587812
Pancreatology. 2005;5(2-3):132-44
15849484
Gut. 2000 Oct;47(4):546-52
10986216
Br J Surg. 2000 Aug;87(8):1019-23
10931044
Nephrol Dial Transplant. 2000 Apr;15(4):502-10
10727545
Gastroenterology. 1992 Nov;103(5):1636-40
1426885
Cytokine. 2005 Nov 3;32(3-4):125-31
16263306
Br J Surg. 1996 May;83(5):633-6
8689205
Pancreas. 1998 Apr;16(3):312-5
9548672
J Gastrointest Surg. 2000 Jul-Aug;4(4):379-87
11058856
Pancreatology. 2002;2(6):565-73
12435871
Br J Surg. 2003 Apr;90(4):407-20
12673741
Langenbecks Arch Surg. 2004 Nov;389(6):475-84
15173946
Free Radic Biol Med. 1997;22(6):947-54
9034233
Curr Opin Investig Drugs. 2001 Apr;2(4):496-501
11566005
Gastroenterology. 2003 Mar;124(3):725-36
12612911
Br J Surg. 2003 Mar;90(3):313-9
12594666
Proc Natl Acad Sci U S A. 1996 Jul 23;93(15):7849-54
8755565
J Pathol. 2000 Feb;190(2):117-25
10657008
Nature. 1995 Sep 7;377(6544):68-71
7659164
J Chin Med Assoc. 2005 Jan;68(1):4-10
15742856
J Clin Gastroenterol. 2002 Feb;34(2):167-76
11782614
Medicina (Kaunas). 2006;42(6):441-9
16816537
Ann Surg. 1985 Dec;202(6):685-93
4073980
Br J Surg. 2001 Jul;88(7):975-9
11442530
Nat Rev Immunol. 2003 Oct;3(10):791-800
14502271
J Gastroenterol Hepatol. 2002 Feb;17 Suppl:S15-39
12000591
Br J Surg. 1993 Oct;80(10):1312-5
7902182
J Hepatobiliary Pancreat Surg. 2006;13(1):48-55
16463211
J Pathol. 2007 Nov;213(3):239-48
17893879
Injury. 2005 Jun;36(6):691-709
15910820
Am J Surg. 1992 Jan;163(1):105-9; discussion 109-10
1733356
Crit Care Med. 2002 Jan;30(1 Supp):S27-S35
11891404
Ann Surg. 2007 Feb;245(2):282-9
17245183
Transpl Int. 2006 Feb;19(2):110-6
16441359
J Gastroenterol. 2006 Aug;41(8):779-84
16988767
Gastroenterology. 1996 Feb;110(2):639-42
8566616
Gut. 2002 Apr;50(4):535-41
11889076
Surgeon. 2006 Feb;4(1):23-31
16459497
Radiology. 1994 Nov;193(2):297-306
7972730
Arch Surg. 1993 May;128(5):586-90
8489394
Br J Surg. 1999 Aug;86(8):1020-4
10460637
Pancreas. 1995 Jul;11(1):95-100
7667248
World J Gastroenterol. 2006 Feb 28;12(8):1219-24
16534874
Ann Surg. 1985 May;201(5):656-65
3994437
World J Gastroenterol. 2006 Sep 7;12(33):5344-51
16981265
J Intensive Care Med. 2006 May-Jun;21(3):160-72
16672638
Gastroenterology. 2005 Jun;128(7):2105-18
15940641
Immunol Rev. 2008 Jun;223:391-421
18613849
Pancreatology. 2001;1(3):201-6
12120194
Am J Surg. 1998 Jan;175(1):76-83
9445247