Alpha-1 protease inhibitor and antichymotrypsin levels in acute pancreatitis

Abstract

AMAÇŞiddetli formundaki yüksek mortalite oranı ile akut pankreatit günümüzde halen tıbbın önemli bir sorunudur. Hastalığın şiddetinin erken belirlenmesi etkin tedavi için kritik öneme sahiptir. Çeşitli biyokimyasal belirteçler denenmiştir ve halen denenmektedir. İdeal belirteç olguyu tanı-yabilmeli ve pankreatitin hafif ve şiddetli formlarını ayırt edebilmelidir. GEREÇ VE YÖNTEMBu prospektif çalışmaya akut pankreatitli 34 olgu (14 erkek, 20 kadın, ort. yaş: 58 yaş) ve kontrol grubundaki 33 olgu (17 erkek, 16 kadın, ort. yaş: 53 yaş) dahil edildi. Hafif (n=29) ve ağır (n=5) olgular başvuru anındaki, başvuru-dan 24 ve 48 saat sonraki amilaz, C-reaktif protein (CRP), alfa-1 proteaz inhibitörü ve antikimotripsin düzeyleri açı-sından karşılaştırıldı. BULGULARAkut pankreatit grubunda alfa-1 proteaz inhibitörü ve antikimotripsinin serum düzeyleri ilk 24 saatte yükseldi, buna karşın CRP 48 saat sonra pik değere ulaştı. CRP şiddet-li pankreatitli hastalarda anlamlı derecede yüksek konsantrasyonlar gösterirken, alfa-1 proteaz inhibitörü ve antikimotripsin düzeylerindeki hafif değişimler anlamlı değildi. SONUÇBaşvuru anında yüksek düzeyleri ile alfa-1 proteaz inhibitörü ve antikimotripsin akut pankreatitte erken sonuçlar verir. Bu değişkenlerin aktivasyonları 24 saat sonra düşer. Bu belirteçlerin akut pankreatitli hastalarda erken tanı değeri olabilir. Her ikisi de bu hastalığın hafif ve şiddetli olgularını ayırmada iyi olmadığından, rutin klinik kullanıma dahil edilmemelidir.Anahtar Sözcükler: Alfa-1 proteaz inhibitor; antikimotripsin; akut pankreatit.

Hepatic steatosis depresses alpha-1-antitrypsin levels in human and rat acute pancreatitis

“…We identified 14 down-regulated proteins or isoforms and four up-regulated proteins in HSAP rat models. Serum levels of AAT, an acute-phase reactant previously showed to be elevated in the serum of patients and animals in the early phase of AP 22 23 24 25 26 , were found to be significantly depressed in HSAP rats compared with NHSAP rats. A previous study suggested that AAT has significant anti-inflammatory properties by affecting a wide range of inflammatory cells such as neutrophils, monocytes, macrophages, and mast cells 36 .…”

“…2c ). We chose to further investigate the expression of AAT, a 52-kD protein previously involved in the pathology of AP 22 23 24 25 26 .…”

“…Imbalance in the synthesis and degradation of proteolytic enzymes and antiproteases has also been implicated in the development of AP. Elevated serum levels of AAT have been detected in AP 23 , and AAT may represent a diagnostic marker of the early phase of AP 24 25 26 . However, the influence of HS on AAT levels in the acute phase of pancreatitis is not known.…”

Protease inhibitors, inflammatory markers, and their association with outcome in dogs with naturally occurring acute pancreatitis

“…Nevertheless, although several of these marker candidates showed promising associations with the severity of AP in humans, reported data are conflicting, with differences among studies in optimal sampling time points, short half-life of some markers (eg, αMGs-trypsin complexes), various tissue protease sources (eg, neutrophil polymorphonuclear elastase) and assay differences. 18,22 In dogs, α 2 MG concentration was significantly decreased in spontaneous AP compared to healthy controls, but was a poor disease severity indicator and was only weakly negatively correlated (r = −.147) with serum trypsin-like immunoreactivity concentration. 23 In another study of dogs with various diseases, α 1 PI concentration was normal, or even increased, in AP cases, 24 in contrast to the hypothesized trend.…”

Clinical effects of low-molecular-weight heparin combined with ulinastatin in children with acute pancreatitis

“…It is easily ignored or misdiagnosed at an early stage, and non-surgical therapy remains the major treatment [2,3]. It has been found that effectively inhibiting the activation and release of pancreatin, cell factors, and inflammatory factors; improving the microcirculation; and adjusting the internal environment in the early period are of great significance in the prognosis of severe acute pancreatitis [4].…”