Relationship Between Plasma Cytokine Concentration and Multiple Organ Failure in Patients with Acute Pancreatitis

Abstract

The dynamic aspects of circulating cytokines and cytokine modulators and their relationship with development of multiple organ failure (MOF) in patients with acute pancreatitis were analyzed. All cytokine and C-reactive protein levels in the circulation were higher than those in the MOF group. In particular, plasma concentrations of soluble tumor necrosis factor receptors (sTNF-RI and sTNF-RII) were significantly higher in patients with MOF than in those without even at admission. Furthermore, plasma concentrations of sTNF-Rs and interleukin-1 (IL-1) receptor antagonist (IL-1ra) were much higher than those of their counterparts, TNFalpha and IL-beta, respectively. These results suggest that the plasma concentrations of sTNF-Rs are useful predictors for the development of MOF, and actions of TNF-alpha and IL-1beta could be regulated by their modulators (soluble receptor and receptor antagonist, respectively) in the pathologic condition of severe acute pancreatitis.

Study progress on mechanism of severe acute pancreatitis complicated with hepatic injury

“…It has extensive bioactivities. Lipsett (2001) and Hirota et al(2000) proved that the occurrence of AP is always accompanied with the rise of inflammatory cytokine, with the extent of rise having close relationship with the disease severity. On the contrary, decreasing TNF-α promotes tissue repair and immune response, and then weakens the chemotaxis of neutrophils.…”

Effect of 5-FU on modulation of disarrangement of immune-associated cytokines in experimental acute pancreatitis

“…Damage caused by trypsin at the initial stage of acute pancreatitis is an event that triggers the systemic inflammatory response syndrome (SIRS) [28] . The pathological process of SIRS results in the clinical manifestation and damage to other distant organs in acute pancreatitis [29,30] . If SIRS persists and anti-inflammatory cytokines are not adequate to suppress this response, SIRS may lead to clinical sepsis and the multiple organ dysfunction syndrome, which could account for one of the main causes of death in severe pancreatitis [31,32] .…”

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

“…Nos decidimos a determinar la IL-18, que algunos autores han considerado como marcador pronóstico de gravedad (14)(15)(16)(17)(18)(19)(20), así como el receptor-I soluble del TNF (sTNFRI) y el antagonista del receptor de la IL-1ß (IL1Ra) teniendo en cuenta, que en estudios previos (24), no se detectaron datos fiables en cuanto a los niveles séricos de sus correspondientes citocinas. En cuanto al sTNFRI, la significación estadística detectada a partir de las 48 horas que se mantiene a las 72 horas y a los 7 días, parece indicar que este pudiera tener valor pronóstico a partir del 2º día, lo cual se ha observado también en otros estudios donde se detecta elevación significativamente mayor del sTNFRI en relación con la gravedad, la existencia de necrosis pancreática y/o fallo multiorgánico (25)(26)(27)(28).…”