title: Soluble urokinase-type plasminogen activator receptor (suPAR) in patients with acute pancreatitis (AP) - Progress in prediction of AP severity.
abstract: BACKGROUND
  Soluble urokinase-type plasminogen activator receptor (suPAR) is a glycoprotein secreted during inflammation and infections. Moreover, increased levels of suPAR are observed after hypoxia and ischaemia. The aim of the study was to assess whether suPAR could represent a useful marker of acute pancreatitis (AP) severity.
  
  
  METHODS
  We have observed a cohort of 126 prospectively enrolled patients. Based on the presence of persistent organ failure (more than 48 h) and local complications (diagnosis of moderate AP [MSAP]), patients were classified into three groups: mild AP (MAP), moderate and severe AP (SAP). The blood samples were taken on admission for detecting suPAR concentrations.
  
  
  RESULTS
  AP was considered severe in 33 patients (26.2%), MSAP was found in 37 patients (29.4%), and MAP was found in 56 patients (44,4%). The AUC for SAP predicted by suPAR was 0.993. The calculated cut-off point for prognosis SAP is 4.75 ng/mL. The BISAP score of ≥3 for detection of SAP had sensitivity and specificity of 94.6% and 63.6%, respectively. The AUC for severity predicted by BISAP amounted to 0.916. Additionally, suPAR turned out to be a good predictor of fatal AP: for the cut-off point 7.05 ng/mL, the AUC was 0.917. The AUC for death prediction in AP patients based on the BISAP score ≥3 was 0.894.
  
  
  CONCLUSIONS
  suPAR concentration is a promising new diagnostic and prognostic indicator in SAP obtainable in the early stage of disease. Larger studies are recommended to evaluate this role further.
authors.affiliation: Department of Gastroenterology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland. Electronic address: michal7lipinski@yahoo.com.
authors.forename: Michal
authors.initials: M
authors.lastname: Lipinski
authors.affiliation: Department of Nephrology and Transplantation, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Rydzewska-Rosolowska
authors.affiliation: Department of Internal Medicine and Nephrology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland; The Faculty of Medicine and Health Sciences, UJK, Kielce, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Rydzewski
authors.affiliation: Diagnostic Laboratory, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Cicha
authors.affiliation: Department of Gastroenterology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland; The Faculty of Medicine and Health Sciences, UJK, Kielce, Poland.
authors.forename: Grazyna
authors.initials: G
authors.lastname: Rydzewska
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C524898:PLAUR protein, human; D055293:Receptors, Urokinase Plasminogen Activator
keywords: Acute pancreatitis; Mortality; Prediction; suPAR