Clinical Research
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2005; 11(34): 5309-5313
Published online Sep 14, 2005. doi: 10.3748/wjg.v11.i34.5309
Different profile of cytokine synthesis according to the severity of acute pancreatitis
Raquel Laveda, Juan Martínez, Carlos Muñoz, Juan Carlos Penalva, Jesus Sáez, Germán Belda, Salvador Navarro, Faust Feu, Anton Mas, José Ma Palazón, José Sánchez-Payá, José Such, Miguel Pérez-Mateo
Raquel Laveda, Juan Martínez, Carlos Muñoz, Juan Carlos Penalva, Jesus Sáez, José Ma Palazón, José Sánchez-Payá, José Such, Miguel Pérez-Mateo, German Belda, Gastroenterology Department and Liver Unit, Hospital General Universitario, Alicante, Spain
Salvador Navarro, Faust Feu, Anton Mas, Institut de Malalties Digestives, Hospital Clínic. Institut d’Investigacions Biomédiques August Pi I Sunyer, Barcelona, Spain
Author contributions: All authors contributed equally to the work.
Supported by grants C03/02 and G03/156 from Instituto de Salud Carlos III (Madrid, Spain)
Correspondence to: Dr. Juan Martínez, Department of Gastroenterology, Hospital General Universitario de Alicante, Pintor Baeza s/n, Alicante 03010, Spain. jmsempere@coma.es
Telephone: +34-96-5938345 Fax: +34-96-5938355
Received: January 24, 2005
Revised: February 13, 2005
Accepted: February 18, 2005
Published online: September 14, 2005
Abstract

AIM: To evaluate the cellular synthetic ability of cytokines involved in pro- and anti-inflammatory reactions in patients with AP.

METHODS: Sixty-seven patients with AP (16 severe, 51 mild) and 10 controls were included in the study. Cultures of whole blood were performed in samples obtained within the first 72 h from the onset of pain. Serum levels of interleukins (IL) 6, 8, 10, and TNF-α were measured at baseline and in the supernatant of cultures with (functional reserve) or without stimulation with phytohemaglutinin.

RESULTS: Basal levels of cytokines were significantly higher in patients with severe AP. A significant increase of all pro-inflammatory cytokines vs basal levels was observed in the supernatant after 24 h of whole blood cultures in patients, but not in controls. In contrast, IL-10 increased significantly in the supernatant of cultures only in patients with mild AP. Cells showed a statistically significant functional reserve for all IL in patients with mild, but only for pro-inflammatory cytokines in patients with severe AP.

CONCLUSION: A marked activation of immune system may be observed in patients with AP, being balanced between pro- and anti-inflammatory cytokines in patients with mild but not severe AP. A reduced functional reserve for the synthesis of IL-10 may be observed in patients with severe AP, which might lead to a worst prognosis.

Keywords: Acute pancreatitis; Cytokines; Severity; Whole blood