Original Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Apr 21, 2010; 16(15): 1845-1853
Published online Apr 21, 2010. doi: 10.3748/wjg.v16.i15.1845
Different profiles of cytokine expression during mild and severe acute pancreatitis
Zilvinas Dambrauskas, Nathalia Giese, Antanas Gulbinas, Thomas Giese, Pascal O Berberat, Juozas Pundzius, Giedrius Barauskas, Helmut Friess
Zilvinas Dambrauskas, Antanas Gulbinas, Laboratory for Research of Digestive System, Institute for Biomedical Research, Eiveniu Str. 2, 50009 Kaunas, Lithuania
Zilvinas Dambrauskas, Antanas Gulbinas, Juozas Pundzius, Giedrius Barauskas, Department of Surgery, Kaunas University of Medicine, Eiveniu Str. 2, 50009 Kaunas, Lithuania
Nathalia Giese, Department of Surgery, Heidelberg University, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
Thomas Giese, Institute for Immunology, Heidelberg University, Im Neuenheimer Feld 305, D-69120 Heidelberg, Germany
Pascal O Berberat, Helmut Friess, Department of Surgery, University of Technology Munich, Ismaninger Str. 22, 81675 Munich, Germany
Author contributions: Dambrauskas Z, Berberat PO and Giese N designed the research; Barauskas G, Pundzius J and Friess H were involved in editing the manuscript; Dambrauskas Z, Giese N, Giese T and Gulbinas A performed the research; Dambrauskas Z and Gulbinas A analyzed the data and wrote the paper.
Correspondence to: Zilvinas Dambrauskas, MD, PhD, Department of Surgery, Kaunas University of Medicine, Eiveniu Str. 2, 50009 Kaunas, Lithuania. zilvinas.dambrauskas@gmail.com
Telephone: +370-37-326218 Fax: +370-37-327163
Received: November 30, 2009
Revised: January 2, 2010
Accepted: January 9, 2010
Published online: April 21, 2010
Abstract

AIM: To study secretion patterns of pro- and anti-inflammatory cytokines, and activation of various cellular subsets of leukocytes in peripheral blood.

METHODS: We have conducted a prospective observational study. One hundred and eight patients with a diagnosis of acute pancreatitis and onset of the disease within last 72 h were included in this study. The mRNA expression of 25 different types of cytokines in white blood cells was determined by quantitative real time polymerase chain reaction. Levels of 8 different cytokines in blood serum were measured by enzyme linked immunosorbent assay. Clinical data and cytokine expression results were subjected to statistical analysis.

RESULTS: Severe and necrotizing acute pancreatitis (AP) is characterized by the significant depletion of circulating lymphocytes. Severe acute pancreatitis is associated with a typical systemic inflammatory response syndrome and over-expression of pro-inflammatory cytokines [interleukin (IL)-6, IL-8, macrophage migration inhibitory factor (MIF)]. Serum IL-6 and MIF concentrations are the best discriminators of severe and necrotizing AP as well as possible fatal outcome during the early course of the disease.

CONCLUSION: Deregulation of cellular immune system is a key event leading to severe and necrotizing AP. IL-6 and MIF could be used as early predictors of complications.

Keywords: Acute pancreatitis; Cytokines; Prognostic factors