Validity of the Urinary Trypsinogen-2 Test in the Diagnosis of Acute Pancreatitis

Mayumi, Toshihiko; Inui, Kentaro; Maetani, Þ Iruru; Yokoe, Masamichi; Sakamoto, Teruo; Yoshida, Masahiro; Ko, Shigeru B. H.; Hirata, Koichi; Takada, Tadahiro

doi:10.1097/mpa.0b013e3182480ab7

Cited by 17 publications

(7 citation statements)

References 20 publications

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“…Therefore, Japanese Criteria seems to be more sensitive and specific than Revised Atlanta Criteria. The sensitivity and specificity of urinary trypsinogen-2 dipstick test in this study coincided with the findings of previous reports[3-9,19]. Mayumi et al[9] reported in Japan for the first time that the urinary trypsinogen-2 dipstick test was able to diagnose or rule out most cases of acute pancreatitis, and the present results are in agreement with the clinical usefulness of the dipstick test despite the small number of patients.…”

Section: Discussionsupporting

confidence: 93%

“…The sensitivity and specificity of urinary trypsinogen-2 dipstick test in this study coincided with the findings of previous reports[3-9,19]. Mayumi et al[9] reported in Japan for the first time that the urinary trypsinogen-2 dipstick test was able to diagnose or rule out most cases of acute pancreatitis, and the present results are in agreement with the clinical usefulness of the dipstick test despite the small number of patients. The urinary trypsinogen-2 dipstick test is based on the same rapid qualitative analysis method as was the rapid influenza diagnostic tests as well as the rapid panel tests for heart-type fatty acid-binding protein.…”

Section: Discussionsupporting

confidence: 93%

“…Trypsinogen-2 is a pancreatic enzyme known to remain elevated longer in patients with acute pancreatitis, with higher levels in the urine than in serum, compared to the commonly measured pancreatic enzyme amylase[2]. A rapid test strip for the detection of urinary trypsinogen-2 was developed in Finland and was reported to be useful for the diagnosis of acute pancreatitis[3-8], and its accuracy and usefulness was also verified in Japan[9].…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan

Yasuda

Kataoka

Takeyama

et al. 2019

WJG

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BACKGROUNDRapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide (TAP) concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIMTo reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODSPatients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012. Urinary and serum samples were collected twice, at enrollment and on the following day for measuring target markers. The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography (CT) Grade of the Japanese Ministry of Health, Labour, and Welfare criteria.RESULTSA total of 94 patients were enrolled during the study period. The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis (sensitivity, 73.1%) and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis (specificity, 62.5%). The area under the curve (AUC) score of urinary trypsinogen-2 according to prognostic factors was 0.704, which was highest in all parameter. The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692, respectively, which shows higher than other pancreatic enzymes. The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSIONWe reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis. Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan

Yasuda

Kataoka

Takeyama

et al. 2019

WJG

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“…Butyrophilin-like protein 10 is an intestinal epithelial protein containing an Ig domain and may regulate T lymphocytes [ 40 , 41 ]. Trypsinogen is a precursor of the enzyme trypsin and is produced in the pancreas and its levels are sometimes used as marker for pancreatitis [ 42 ]. The corticosteroid-binding globulin protein binds circulating plasma cortisol and may play hormonal roles, possibly in mares, especially during pregnancy when its plasma concentration decreases [ 43 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

Serial-omics characterization of equine urine

2017

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Horse urine is easily collected and contains molecules readily measurable using mass spectrometry that can be used as biomarkers representative of health, disease or drug tampering. This study aimed at analyzing microliter levels of horse urine to purify, identify and quantify proteins, polar metabolites and non-polar lipids. Urine from a healthy 12 year old quarter horse mare on a diet of grass hay and vitamin/mineral supplements with limited pasture access was collected for serial-omics characterization. The urine was treated with methyl tert-butyl ether (MTBE) and methanol to partition into three distinct layers for protein, non-polar lipid and polar metabolite content from a single liquid-liquid extraction and was repeated two times. Each layer was analyzed by high performance liquid chromatography—high resolution tandem mass spectrometry (LC-MS/MS) to obtain protein sequence and relative protein levels as well as identify and quantify small polar metabolites and lipids. The results show 46 urine proteins, many related to normal kidney function, structural and circulatory proteins as well as 474 small polar metabolites but only 10 lipid molecules. Metabolites were mostly related to urea cycle and ammonia recycling as well as amino acid related pathways, plant diet specific molecules, etc. The few lipids represented triglycerides and phospholipids. These data show a complete mass spectrometry based—omics characterization of equine urine from a single 333 μL mid-stream urine aliquot. These omics data help serve as a baseline for healthy mare urine composition and the analyses can be used to monitor disease progression, health status, monitor drug use, etc.

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“…They are not readily available and additional studies are needed to determine their role in the diagnosis of acute pancreatitis. [43][44][45][46] Acute pancreatitis is also associated with elevations in C-reactive protein (CRP), IL-6, IL-8, IL-10, TNF, and PMN elastase. 46 A CRP level above 150 mg/dL within 48 h is associated with severe pancreatitis.…”

Section: Laboratory Findingsmentioning

confidence: 99%

The management of the patient with acute pancreatitis: from evidence to clinical practice

Cenci

Restuccia

Gnerre³

et al. 2017

Ital J Med

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Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain and elevation of pancreatic enzymes in the blood. The pathogenesis is complex and partly unknown and the evolution is often unpredictable. Many efforts have been made to define this disease and its complications and to classify different grades of severity in order to formulate prognostic scores that could guide the physician in choosing the optimal therapeutic setting and procedures. The management of the patient with pancreatitis is not always optimal and differs among internist, gastroenterologist or surgeon. We think that a patient with clinical suspicion of acute pancreatitis is admitted to medical or surgical department depending on the availability of beds and not according to evidence-based medicine. The aim of this monograph is to identify the optimal management of patients with acute pancreatitis admitted to hospital.

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Validity of the Urinary Trypsinogen-2 Test in the Diagnosis of Acute Pancreatitis

Abstract: This simple, rapid, easy, and noninvasive urinary trypsinogen-2 test can diagnose or rule out most cases of acute pancreatitis.

Cited by 17 publications

References 20 publications

Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan

Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan

Serial-omics characterization of equine urine

The management of the patient with acute pancreatitis: from evidence to clinical practice

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