Early Prediction of Persistent Organ Failure by Serum Angiopoietin-2 in Patients with Acute Pancreatitis.
Biomarkers for the early prediction of the severity of acute pancreatitis (AP) are urgently needed for clinical management of the disease. Angiopoietin-2 (Ang-2), one of the autocrine peptides that reduce endothelial permeability, has been found to be associated with various diseases, including inflammatory disorders.



This study aimed to determine whether serum Ang-2 could serve as a noninvasive biomarker for the early prediction of persistent organ failure (POF) in acute pancreatitis.



A total of 120 AP patients were prospectively enrolled at Jinling Hospital. Serum samples were collected on admission. Clinical and laboratory data were recorded. Ang-2 levels were measured by enzyme-linked immunosorbent assay.



A total of 37 patients developed POF and were classified as having severe AP (SAP). Ang-2 was significantly higher on admission in patients who developed POF than in those who did not (p < 0.001 for all). Furthermore, receiver operating characteristic (ROC) curve analysis revealed that Ang-2 could distinguish patients who developed POF from mild AP (MAP, area under ROC curve [AUC] = 0.88, 95 % CI 0.78-0.94) and moderately severe AP patients (MSAP, AUC = 0.74, 95 % CI 0.63-0.83). In addition, multivariate logistic regression showed that increased Ang-2 was an independent predictor of developing POF between subgroups with MSAP and SAP (OR 7.2, 95 % CI 2.7-19.4) and among all AP patients (OR 12.1, 95 % CI 4.8-30.3).



Elevated serum Ang-2 levels on admission may be a promising biomarker for the prediction of POF in AP.
Department of Gastroenterology and Hepatology, Jinling Hospital, Southern Medical University, Nanjing, 210002, China.
Yu-Ping
YP
Zhang
Department of Gastroenterology and Hepatology, Jinling Hospital, Southern Medical University, Nanjing, 210002, China.
Chang
C
Liu
Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing University, Nanjing, 210002, China.
Lei
L
Ye
Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing University, Nanjing, 210002, China.
Na
N
Yu
Department of Gastroenterology and Hepatology, Jinling Hospital, Southern Medical University, Nanjing, 210002, China.
Yuan-Ning
YN
Ye
Department of Gastroenterology and Hepatology, Jinling Hospital, Clinical School of Nanjing, Second Military Medical University, Nanjing, 210002, China.
Wen-Rong
WR
Sun
Department of Gastroenterology and Hepatology, Jinling Hospital, Southern Medical University, Nanjing, 210002, China.
Lin
L
Wu
Department of Gastroenterology and Hepatology, Jinling Hospital, Southern Medical University, Nanjing, 210002, China. wangfy65@nju.edu.cn.
Fang-Yu
FY
Wang
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D042702:Angiopoietin-2 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D042882:Gallstones / Q000150:complications; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000453:epidemiology; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D019512:Pancreatitis, Alcoholic / Q000097:blood / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D051437:Renal Insufficiency / Q000097:blood* / Q000453:epidemiology; D012131:Respiratory Insufficiency / Q000097:blood* / Q000453:epidemiology; D012720:Severity of Illness Index
C586513:ANGPT2 protein, human; D042702:Angiopoietin-2; D015415:Biomarkers; D002097:C-Reactive Protein
Acute pancreatitis; Angiopoietin-2; Early prediction; Persistent organ failure
Crit Care. 2015 Mar 17;19:88
25851781
Am J Gastroenterol. 2011 Oct;106(10 ):1859-61
21979214
Am J Gastroenterol. 2009 Jan;104(1):164-70
19098865
Gastroenterology. 2013 Jun;144(6):1252-61
23622135
Trends Immunol. 2006 Dec;27(12):552-8
17045842
Crit Care. 2009;13(3):R64
19416526
Shock. 2009 Apr;31(4):348-53
18791490
J Am Coll Surg. 2014 May;218(5):1074
24745571
Crit Care Med. 2007 Jan;35(1):199-206
17110873
Circulation. 2004 Oct 19;110(16):2355-60
15302795
J Am Coll Surg. 2014 Jan;218(1):26-32
24355874
Gut. 2013 Jan;62(1):102-11
23100216
Science. 1997 Jul 4;277(5322):55-60
9204896
Nature. 2000 Sep 14;407(6801):242-8
11001067
Blood. 2004 Jun 1;103(11):4150-6
14976056
Eur J Gastroenterol Hepatol. 2013 Jul;25(7):784-9
23492986
Eur J Gastroenterol Hepatol. 1998 Jul;10(7):611-7
9855088
Curr Gastroenterol Rep. 2004 Apr;6(2):99-103
15191686
J Clin Gastroenterol. 2011 Aug;45(7):630-7
21750433
Am J Gastroenterol. 2010 Oct;105(10):2287-92
20461065
Surg Gynecol Obstet. 1974 Jul;139(1):69-81
4834279
Crit Care Med. 1985 Oct;13(10):818-29
3928249
Thorax. 2008 Oct;63(10):903-9
18559364