Proinflammatory Cytokines in Early Assessment of the Prognosis of Acute Pancreatitis

Chen, Chun-Chia; Wang, Sun-Sang; Lee, Fa-Yauh; Chang, Full‐Young; Lee, Shou‐Dong

doi:10.1111/j.1572-0241.1999.00709.x

Cited by 159 publications

(71 citation statements)

References 19 publications

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“…Among these cytokines, IL-6 is considered to play crucial roles (6,7). Several clinical studies have reported that serum IL-6 is elevated at the early stage of acute pancreatitis (9,10), and that the severity and systemic complications of acute pancreatitis depend on proinflammatory cytokines, including IL-6 (1, 2). However, it remains unclear which cells are secreting IL-6 in the pancreas.…”

Section: Discussionmentioning

confidence: 99%

IL-6 Secretion by Human Pancreatic Periacinar Myofibroblasts in Response to Inflammatory Mediators

Shimada

Andoh

Hata

et al. 2002

The Journal of Immunology

131

116

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There is increasing evidence that IL-6 plays an important role in the pathophysiology of acute pancreatitis via its broad proinflammatory actions. To identify the local biosynthetic site for IL-6 in human pancreas, we investigated IL-6 secretion in human pancreatic periacinar myofibroblasts. IL-6 secretion was determined by ELISA and Northern blotting. The activation of NF-κB was assessed by EMSA. The activation of mitogen-activated protein kinase (MAPK) was assessed by immunoblotting. IL-6 secretion was rapidly induced by IL-17, IL-1β, and TNF-α. EMSAs demonstrated that IL-17, IL-1β, and TNF-α induced NF-κB activation within 1.5 h after stimulation, and a blockade of NF-κB activation by the pyrrolidine derivative of dithiocarbamate and tosyl-phe-chloromethylketone markedly reduced the IL-17-, IL-1β-, or TNF-α-induced IL-6 gene expression. Furthermore, IL-17, IL-1β, and TNF-α induced a rapid activation of extracellular signal-related kinase p42/44 and p38 MAPKs, and specific MAPK inhibitors (SB203580, PD98059, and U0216) significantly reduced IL-17-, IL-1β-, or TNF-α-induced IL-6 secretion, indicating the role of MAPKs in the induction of IL-6. The combination of either IL-17 plus IL-1β or IL-17 plus TNF-α enhanced IL-6 secretion and IL-6 mRNA expression; in particular, the effects of IL-17 plus TNF-α were much stronger than those induced by IL-17 plus IL-1β. TNF-α-induced IL-6 mRNA degraded rapidly at any concentrations, and the combination of IL-17 and TNF-α markedly enhanced IL-6 mRNA stability. This indicates that the effects of IL-17 plus TNF-α were regulated at the post-transcriptional level. In conclusion, pancreatic periacinar myofibroblasts secreted a large amount of IL-6 in response to proinflammatory cytokines. These cells might play an important role in the pathogenesis of acute pancreatitis via IL-6 secretion.

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Section: Discussionmentioning

confidence: 99%

IL-6 Secretion by Human Pancreatic Periacinar Myofibroblasts in Response to Inflammatory Mediators

Shimada

Andoh

Hata

et al. 2002

The Journal of Immunology

131

116

View full text Add to dashboard Cite

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“…Hallazgos similares son los obtenidos por Heresbach (30) y Mayer (18), aunque la mayoría de las publicaciones detectan los valores máxi-mos antes de las 48 horas (31)(32)(33)(34)(35). En cualquier caso, la IL-6 es considerada la más útil clínicamente como marcador de gravedad (35)(36)(37)(38)(39). Algunos estudios sugieren que la asociación de IL-6 y lipasa pudieran ser buenos parámetros de diagnóstico y pronóstico en la práctica clí-nica diaria (34).…”

Section: Discussionunclassified

Interleucina-18 (IL-18) y otros parámetros inmunológicos como marcadores de gravedad en la pancreatitis aguda

Martín¹,

Saracibar²,

Santa-Maria³

et al. 2008

Rev. esp. enferm. dig.

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A pesar de que en la actualidad poseemos conocimientos más profundos sobre la fisiopatología de la pancreatitis aguda (PA), y que disponemos de mejores medios terapéuticos fundamentalmente a nivel de cuidados intensivos, sin embargo se mantiene una elevada morbili- RESUMENObjetivo: se trata de comparar prospectivamente el comportamiento durante la primera semana del ingreso de los niveles de interleucina-18 (IL-18), y otros parámetros inmunológicos entre pacientes con pancreatitis aguda con y sin criterios de gravedad, así como entre pacientes con y sin desarrollo ulterior de seudoquiste.Pacientes y métodos: se compararon en 36 pacientes con pancreatitis aguda los resultados de sTNF-RI, IL-1Ra, IL-6 e IL-18 los días 1, 2, 3 y 7 desde el ingreso entre pancretitis leve, grave y un grupo control (13 pacientes) con cólico biliar simple, así como entre pacientes con o sin seudoquiste.Resultados: al comparar pancreatitis leve con grave, IL-18 fue significativamente superior sólo el primer día en las pancreatitis graves y los otros parámetros a partir del segundo día de forma mantenida. También en pacientes que desarrollaron seudoquiste, IL-18 estuvo significativamente elevada el primer día.Conclusiones: IL-18 resultó el marcador más precoz de complicaciones y gravedad de la pancreatitis aguda a nivel sistémico y local (seudoquiste).Palabras clave: Interleucina-18. Pancreatitis aguda. Gravedad. Seudoquiste. ABSTRACTObjective: our aim was to prospectively compare the behavior of interleukin 18 (IL-18) levels and other immunological parameters during the first week of hospitalization between acute pancreatitis patients with and without severity criteria, as well as between patients with and without late pseudocyst development.Patients and methods: in 36 patients with acute pancreatitis we compared sTNF-RI, IL-1Ra, IL-6, and IL-18 levels at days 1, 2, 3 and 7 after hospitalization between mild pancreatitis, severe pancreatitis, and a "control" group (13 patients) with uncomplicated biliary colic, as well as between patients with and without pseudocyst.Results: on comparing mild to severe pancreatitis, IL-18 was significantly higher only the first day in severe pancreatitis, while the other parameters were steadily higher after the second day. In patients developing pseudocyst, IL-18 was also noticeably higher the first day.Conclusions: IL-18 appears to be the earliest marker of complications and severity in acute pancreatitis at both the systemic and local level (pseudocyst).

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“…This results in an imbalance between pro-and anti-inflammatory cytokines, resulting in the development of SIRS. Some mediators, such as TNF-alpha, phospholipase, and kinin, are increased greatly in animal models of SAP [9] , and some studies have shown that there is a significant correlation between the serum levels of IL-1-beta, IL-6, IL-8, IL-10 and IL-11 and the severity of acute pancreatitis [24][25][26][27] . Animal studies have shown that early blockade of the cytokine cascade at the level of the IL-1 receptor significantly decreases the severity of pancreatitis and intrinsic pancreatic damage, as well as the mortality from SAP [28,29] .…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of early veno-venous hemofiltration for severe acute pancreatitis in China

Jiang

Chen²,

Xia³

et al. 2008

WJG

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AIM:To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis (SAP) in China. METHODS:We carried out a search of Pub-Medline and Chinese Biomedical Disk database. Controlled clinical trials on Chinese population were included in the analysis. The four decision branches that were analyzed were: continuous or long-term veno-venous hemofiltration (CVVH/LVVH), short-term veno-venous hemofiltration (SVVH), SVVH plus peritoneal dialysis (PD), and non-hemofiltration control group. The effectiveness of the technique was determined by survival rate, complications prevention and surgery preservation. The total cost of hospitalization was also assessed. RESULTS:The SVVH only technique was the least costly modality, $5809 (44 449 RMB), and was selected as the baseline treatment modality. SVVH only arm achieved the lowest C/E ratio in terms of overall survival, complications prevention and surgery preservation. In incremental cost-effectiveness analysis, the CVVH/ LVVH only and the control arms were inferior to other techniques. Sensitivity analysis showed SVVH only and SVVH plus PD arms overlapped in C/survival ratio. C O N C L U S I O N :T h e r o l e o f e a r l y v e n o -v e n o u s hemofiltration as an alternative therapy for SAP remains controversial. However, we propose that early use of short-term high-volume veno-venous hemofiltration would have a beneficial impact on the management of SAP.

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Proinflammatory Cytokines in Early Assessment of the Prognosis of Acute Pancreatitis

Abstract: Among the proinflammatory cytokines, interleukin-6 is the most useful parameter for early prediction of the prognosis of acute pancreatitis.

Cited by 159 publications

References 19 publications

IL-6 Secretion by Human Pancreatic Periacinar Myofibroblasts in Response to Inflammatory Mediators

IL-6 Secretion by Human Pancreatic Periacinar Myofibroblasts in Response to Inflammatory Mediators

Interleucina-18 (IL-18) y otros parámetros inmunológicos como marcadores de gravedad en la pancreatitis aguda

Cost-effectiveness analysis of early veno-venous hemofiltration for severe acute pancreatitis in China

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