title: Serum matrix Gla protein concentrations in patients with mild and severe acute pancreatitis.
abstract: BACKGROUND
  Acute pancreatitis (AP) causes an increase in proinflammatory cytokine and acute phase protein levels. Our previous studies in AP showed the role of fetuin A as a negative acute phase protein. Matrix Gla protein (MGP), beside fetuin A, is one of the main inhibitors of extraosseous calcification. In the present preliminary study we evaluated the relationship between MGP, lipase, and inflammation in AP patients.
  
  
  METHODS
  The study included 40 patients with AP of diverse severity (28 mild, 12 severe), assessed during the early phase of AP (day 1 - day 7 of hospitalization). The concentration of MGP, fetuin A, polymorphonuclear elastase (PMN-elastase), interleukin 6 (IL-6), interleukin 18 (IL-18), hepatocyte growth factor (HGF), high sensitivity tumor necrosis factor alpha (hs TNFalpha), soluble receptor of tumor necrosis factor II (sTNFRII), and neopterin were measured by ELISA kits; albumin, lipase and amylase were measured on a Modular P Chemistry Analyser (Roche Diagnostica, Germany); procalcitonin (PCT) was measured using the LUMItest PCT (Brahms, Germany), and serum amyloid A (SAA) and high sensitivity C-reactive protein (hs CRP) were measured using an immunonephelometric method on a Nephelometer BNII (Siemens Healthcare, Germany).
  
  
  RESULTS
  MGP positively correlated with lipase activity (R = 0.64; p < 0.05) on day 1 after admission to hospital. Lower MGP levels were consistent with higher intensity of inflammation, as MGP significantly (p < 0.05) inversely correlated with IL-6 (R = -0.48 on day 3; R = -0.46 on day 5 and R = -0.52 on day 7 after admission), IL-18 (R = - 0.55; R = -0.60; R = -0.48 on day 1, day 3, and day 5, respectively), HGF (R = -0.58 on day 3), hs TNFalpha (R = -0.45 on day 1 and R = -0.64 on day 5), its soluble receptor sTNFRII (R = -0.63; R = -0.61; R = -0.59 on day 3, day 5, and day 7, respectively), hs CRP (R = -0.76 on day 1 and R = -0.83 on day 5), PCT (R = -0.62 on day 1 and R = -0.59 on day 7), SAA (R = -0.45 on day 5) as well as with neopterin (R = -0.52 on day 1 after admission). MGP levels dropped simultaneously with fetuin A (R = 0.50 on day 3; R = 0.60 on day 5 and R = 0.63 on day 7) and albumin concentrations (R = 0.51; R = 0.70; R = 0.94 on day 1, day 5, and day 7 day after admission, respectively). There was a relationship between lipase activity and MGP concentration on day 1 of hospitalization (R = 0.64; p < 0.05).
  
  
  CONCLUSIONS
  Our preliminary results indicate that the MGP level correlated negatively with all of the proinflammatory cytokines and acute phase proteins studied in patients with AP, and positively with lipase, fetuin A, and albumin measurements. These findings may indicate the role of MGP in calcium and phosphate metabolism disturbances in the course of AP.
authors.affiliation: Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kopernika 15A, 31-501 Krakow, Poland. mbkusnie@cyf-kr.edu.pl
authors.forename: Beata
authors.initials: B
authors.lastname: Kusnierz-Cabala
authors.forename: Anna
authors.initials: A
authors.lastname: Gurda-Duda
authors.forename: Bogdan
authors.initials: B
authors.lastname: Solnica
authors.forename: Danuta
authors.initials: D
authors.lastname: Fedak
authors.forename: Paulina
authors.initials: P
authors.lastname: Dumnicka
authors.forename: Jozefa
authors.initials: J
authors.lastname: Panek
authors.forename: Jan
authors.initials: J
authors.lastname: Kulig
mesh_terms: D000208:Acute Disease; D000209:Acute-Phase Proteins / Q000032:analysis; D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000097:blood / Q000209:etiology; D002118:Calcium / Q000378:metabolism*; D002135:Calcium-Binding Proteins / Q000097:blood* / Q000502:physiology; D016207:Cytokines / Q000097:blood; D016326:Extracellular Matrix Proteins / Q000097:blood* / Q000502:physiology; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000150:complications; D010758:Phosphorus / Q000378:metabolism*; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis; D000097568:Matrix Gla Protein
chemical_list: D000209:Acute-Phase Proteins; D002118:Calcium; D002135:Calcium-Binding Proteins; D016207:Cytokines; D016326:Extracellular Matrix Proteins; D008049:Lipase; D010758:Phosphorus; D012709:Serum Albumin; D060749:alpha-2-HS-Glycoprotein; D000097568:Matrix Gla Protein