Title: Proinflammatory cytokines IL-6, IL-8 and C-reactive protein in acute pancreatitis - the role of IL-8 in prognosing complications
- Andrzej Lewandowski, Wacław Kopeć, Dorota Diakowska, Maciej Garbień
- Original articles
- Polish Gastroenterology
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- Final page:
- proinflammatory cytokines, C-reactive protein, acute pancreatitis, complications
Introduction: Severe pancreatitis is connected with high mortality ratę. The studies on inflammatory markers both in severe and mild pancreatitis show that proinflammatory cytokines can be helpful in differential diagnosis.
Aim of study:The aim of the study was to assess the dynamics of selected cytokines (IL-6, IL-8) and C-reactive protein (CRP) in patients with mild and severe pancreatitis.
Material and methods: The studied group consisted of 35 patients, F- 15, M - 20, aged 21 to 87 years (average 54±33 years). Levels of IL-6, IL-8 and CRPweredetermined in all patients on days 1,3, 7,14 of hospitalization. Obtained results were analysed statistically and shown in graphs. The patients were divided into 2 groups: with mild and severe pancreatitis. In 20 patients pancreatitis was classified as mild, whereas in 15 patients pancreatitis was classified assevere. In 20 patients with mild pancreatitis only pharmacological therapy and in 15withsevere pancreatitis surgical procedures were applied.
Results: Biochemical analysis showed that in patients with mild pancreatitis the average level of IL-6 was 9.83 pg/ml (SD±4.84) on 1st day, and 7.47 pg/ml (SD±5.83) on day 14th. In patients with mild pancreatitis the average level of IL-8 was 4.76 pg/ml (SD±2.42) on lst day and 5.12 pg/ml (SD±4.43) on day 14th. The average level of CRP in patients with mild pancreatitis slightly exceeded the norm set for healthy people and it was 5.66 mg/l (SD±0.69) on 1st day, and 5.6 mg/l (SD±1.07) on day 14th.The average levels of IL-6 in patients with severe pancreatitis were sixtimes higherthan those in patients with mild pancreatitis, 58.38 pg/ml (SD±53.6)onday lst and 65.93 pg/ml (SD±46.85)onday 14th. The average levels of IL-8 in patients with severe pancreatitis were 15.81 pg/ml (SD± 12.87) on the lst day, 18.71 pg/ml (SD±13.9) on the 3rd day, 18.61 pg/ml (SD±13.86) on the 7th day and 18.83 pg/ml (SD±13.65) on the 14th day respectively. The average levels of CRP in severe pancreatitis were 14.08 mg/l (SD±11.41) on the lst day, 17.07 mg/l (SD±16.3) on the 3rd day, 16.07 mg/l (SD±10.36) on the 7th day and 15.75 mg/l (SD±9.56) on the 14th day. Considering the diagnostic value of IL-8 in the inflammation of the pancreas in reference to IL-6 and CRP it se-ems that this chemokine reflects the seriousness of the course of inflammation better than different studied cytokines and confirms the facts in literaturę that it is perceived as a lethal cytokine. Conclusions:
1. IL-6 and CRP are sensitive and early proinflammatory markers of the inflammatory process in patients with acute pancreatitis.
2. The profile of IL-8 concentrations remains on higherlevel in research cycle, which can suggest that this chemokine reflects the seriousness of the course of inflammation better than other studied cytokines and is perceived asa lethal cytokine.