B cell activating factor of the tumor necrosis factor family (BAFF) behaves as an acute phase reactant in acute pancreatitis.
OBJECTIVE
To determine if B cell activating factor of the tumor necrosis factor family (BAFF) acts as an acute phase reactant and predicts severity of acute pancreatitis.


METHODS
40 patients with acute pancreatitis were included in this single center cohort pilot study. Whole blood and serum was analyzed on day of admission and nine consecutive days for BAFF, c-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and leucocyte numbers. Different severity Scores (Ranson, APACHE II, SAPS II, SAPS III) and the clinical course of the patient (treatment, duration of stay, duration ICU) were recorded.


RESULTS
Serum BAFF correlates with CRP, an established marker of severity in acute pancreatitis at day of admission with a timecourse profil similar to IL-6 over the first nine days. Serum BAFF increases with Ranson score (Kruskal-Wallis: Chi2 = 10.8; p = 0.03) similar to CRP (Kruskal-Wallis: Chi2 = 9.4; p = 0.05 ). Serum BAFF, IL-6, and CRP levels are elevated in patients that need intensive care for more than seven days and in patients with complicated necrotizing pancreatitis. Discriminant analysis and receiver operator characteristics show that CRP (wilks-lambda = 0.549; ROC: AUC 0.948) and BAFF (wilks-lambda = 0.907; ROC: AUC 0.843) serum levels at day of admission best predict severe necrotizing pancreatitis or death, outperforming IL-6, PCT, and number of leucocytes.


CONCLUSIONS
This study establishes for the first time BAFF as an acute phase reactant with predictive value for the course of acute pancreatitis. BAFF outperforms established markers in acute pancreatitis, like IL-6 and PCT underscoring the important role of BAFF in the acute inflammatory response.
Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany. georg.pongratz@ukr.de
Georg
G
Pongratz
Hannah
H
Hochrinner
Rainer H
RH
Straub
Stefanie
S
Lang
Tanja
T
Brünnler
D000208:Acute Disease; D000328:Adult; D000368:Aged; D053264:B-Cell Activating Factor / Q000097:blood / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000378:metabolism*; D011446:Prospective Studies; D011498:Protein Precursors / Q000378:metabolism
D053264:B-Cell Activating Factor; C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; C505719:TNFSF13B protein, human; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide