Messmann, Helmut and Vogt, Wolfgang and Falk, Werner and Vogl, Daniela and Zirngibl, Hubert and Leserf, Hans-Georg and Schoelmerich, Juergen (1998) Interleukins and their antagonists but not TNF and its receptors are released in post-ERP pancreatitis. EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 10 (7). pp. 611-617. ISSN 0954-691X,
Full text not available from this repository. (Request a copy)Abstract
Objective Usually it is not possible to study the initial systemic response in patients with acute pancreatitis in the first hours after onset of the disease. We used post-endoscopic retrograde pancreatography (ERP) pancreatitis as a model to study cytokine and anticytokine release in the early phase of human acute pancreatitis. Methods Post-ERP pancreatitis was defined as a threefold increase in serum amylase and at least two of the following clinical symptoms: abdominal pain, nausea, vomiting or peritonism 24 h after ERP. Serum levels of pro-inflammatory cytokines interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), interleukin-8 (IL-8), tumour necrosis factor alpha (TNF), as well as endogenous antagonistic mediators of the systemic inflammatory response such as soluble tumour necrosis factor alpha receptors p55 (TNFR p55) and p75 (TNFR p75), and IL-l-receptor antagonist (IL-I-RA) and interleukin-2-receptor (IL-2R) as indicators of lymphocyte activation were measured before and 0, 1, 4, 12, 24 and 48 h after ERP, In nine patients with acute post-ERP pancreatitis, these parameters were monitored daily until C-reactive protein (CRP) was within normal ranges and were compared to patients without pancreatitis after ERP. Results IL-1 beta was not detectable in five patients with and four patients without post-ERP pancreatitis. The values of the remaining patients in both groups were lower than 3.9 pg/ml, IL-8 and IL-I-RA serum concentrations peaked 12 h after ERP (132.9 and 3245.0 pg/ml respectively) compared to patients without post-ERP pancreatitis (25.8 and 389.9 pg/ml respectively). The IL-6 concentration increased to 81.6 pg/ml (8.0 pg/ml in control patients) 24 h after ERP, while the peak values for CRP were measured 72 h after ERP (164.0 versus 7.7 mg/l), IL-2R content was maximally elevated 144 h after ERP (688.8 versus 255.9 U/ml), while concentrations of TNF and its receptors showed no significant change over time. Conclusion The initial response of the cytokine network to damage of the human pancreas leading to acute pancreatitis includes the release of IL-8 and the IL-1 beta antagonist Il-1-RA, while IL-1 beta is not found in the systemic circulation. The TNF system does not seem to be involved as indicated by the lack of detectable changes in TNF and the soluble TNFR p55 and p75 serum concentrations, Lymphocyte activation as indicated by elevated IL-2R levels occurred days after the initial trauma. Even mild post-ERP pancreatitis leads to significant systemic release of cytokines and their biological counterparts. (C) 1998 Lippincott-Raven Publishers.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | C-REACTIVE PROTEIN; SERUM INTERLEUKIN-6; SEVERITY; PRECEDES; SEPSIS; post-ERP pancreatitis; cytokines; anti-cytokines |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 May 2023 07:00 |
| Last Modified: | 09 May 2023 07:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/49692 |
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