title: Cytokines and organ failure in acute pancreatitis: inflammatory response in acute pancreatitis.
abstract: OBJECTIVE
  We aimed at synchronously examining the early time course of 4 proinflammatory cytokines as predictive factors for development of organ failure in patients with acute pancreatitis (AP).
  
  
  METHODS
  Interleukin (IL) 6, IL-8, IL-18, and tumor necrosis factor α were measured on admission and at days 1, 2, and 14 in 60 patients admitted with first attack of AP. The prediction of single-organ and multiorgan failure from the cytokine profiles was evaluated by receiver operating characteristic analyses.
  
  
  RESULTS
  Interleukin 6 and IL-8 levels were significantly higher in patients who developed renal, respiratory, and circulatory failure, as was the case for patients with multiorgan failure. Interleukin 18 levels were significantly elevated in renal and respiratory failure only. Tumor necrosis factor α was significantly elevated in all types of organ failures, except for intestinal failure.
  
  
  CONCLUSIONS
  Synchronous measurements of 4 cytokines demonstrated IL-6 and IL-8 to be predictive as early surrogate markers with regard to organ failures in AP. The fact that all of the cytokines were particularly elevated in patients with organ failures calls for evaluation of agents modifying the severe inflammatory response in patients with AP.
authors.affiliation: Department of Surgery K, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. malmstroem@gmail.com
authors.forename: Marie Louise
authors.initials: ML
authors.lastname: Malmstrøm
authors.forename: Mark Berner
authors.initials: MB
authors.lastname: Hansen
authors.forename: Anders Møller
authors.initials: AM
authors.lastname: Andersen
authors.forename: Annette Kjær
authors.initials: AK
authors.lastname: Ersbøll
authors.forename: Ole Haagen
authors.initials: OH
authors.lastname: Nielsen
authors.forename: Lars Nannestad
authors.initials: LN
authors.lastname: Jørgensen
authors.forename: Srdan
authors.initials: S
authors.lastname: Novovic
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016207:Cytokines / Q000097:blood*; D003718:Denmark; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D020382:Interleukin-18 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000209:etiology* / Q000276:immunology; D010195:Pancreatitis / Q000097:blood / Q000150:complications* / Q000276:immunology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology* / Q000276:immunology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: C508606:CXCL8 protein, human; D016207:Cytokines; C508600:IL6 protein, human; D018836:Inflammation Mediators; D020382:Interleukin-18; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha