title: The relation between serum cytokeratin 18 and acute pancreatitis: can it be a serological predictive marker?
abstract: OBJECTIVE
  Acute pancreatitis is well defined as pancreatic inflammation due to the activation of pancreatic enzymes secondary to several etiological factors. In the majority of patients, the clinical symptoms are self-limited, but it can also cause tissue necrosis and severe organ failures. In experimental animal models, it has been shown that wide apoptotic cell death is related to a clinically mild presentation of acute pancreatitis. Cytokeratin 18, a cytoskeletal protein, is shown to be related with apoptosis. In this study, we aimed to show the relation between serum cytokeratin 18 and the clinical presentation of acute pancreatitis in humans.
  
  
  METHODS
  A total of 54 acute pancreatitis patients were enrolled into the study. Patients were classified as mild or severe pancreatitis according to Ranson's criteria. There were 36 (66.7%) patients in the mild pancreatitis group (score < 6), and 18 (33.3%) patients in the severe pancreatitis group (score ≥ 6). During the first admission, blood samples were obtained for serum cytokeratin 18 levels.
  
  
  RESULTS
  Cytokeratin 18 levels in the mild pancreatitis group were significantly higher than in the severe pancreatitis group (271.2 ± 45.5 vs. 152.6 ± 38.2 IU/L; p < 0.001). There was a negative correlation between the disease activity score (Ranson score) and the serum cytokeratin 18 levels (p < 0.001; r = -0.724).
  
  
  CONCLUSIONS
  This first human study suggests that cytokeratin 18 (marker of apoptosis) might be a serological predictive marker for acute pancreatitis for disease activity.
authors.affiliation: Gaziantep University Faculty of Medicine, Department of Gastroenterology, Gaziantep, Turkey. ikoruk@hotmail.com
authors.forename: İrfan
authors.initials: İ
authors.lastname: Koruk
authors.forename: Hakan
authors.initials: H
authors.lastname: Özdemır
authors.forename: Musa
authors.initials: M
authors.lastname: Aydinli
authors.forename: Neslihan
authors.initials: N
authors.lastname: Bekmen
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tarakçioğlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Koruk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D053538:Keratin-18 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; C488421:KRT18 protein, human; D053538:Keratin-18