eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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2/2018
vol. 14
 
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abstract:
Clinical research

Inflammatory mediators in the diagnosis and treatment of acute pancreatitis: pentraxin-3, procalcitonin and myeloperoxidase

Osman Simsek, Ahmet Kocael, Pınar Kocael, Anıl Orhan, Mahir Cengiz, Huriye Balcı, Kenan Ulualp, Hafize Uzun

Arch Med Sci 2018; 14, 2: 288–296
Online publish date: 2018/02/21
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Introduction: Acute pancreatitis (AP) is the third most common gastrointestinal disease at hospital admission. The etiology and pathogenesis of this disease are not completely clear. Our study was intended to determine the systemic levels of pentraxin-3 (PTX-3), myeloperoxidase (MPO), procalcitonin (PCT), and C-reactive protein (CRP) as prognostic parameters in early stages of AP. We also determined the effects of treatment on PTX-3, MPO, PCT and CRP levels in AP.

Material and methods: The study group comprised 44 AP patients (22 male, 22 female; age: 49.3 ±16.9 years) referred to our outpatient clinic. Additionally, our investigation included a control group of 30 healthy volunteers (18 male, 12 female; age: 50.8 ±12.6 years).

Results: Leukocytes, glucose, aspartate aminotransferase (AST (SGOT)), alanine aminotransferase (ALT (SGPT)), alkaline phosphatase (ALP), total and direct bilirubin levels were significantly higher in the AP group (p < 0.05, all). CRP, PTX-3, MPO and PCT were considerably higher in the AP group (p < 0.001, all), and after treatment, CRP, PTX-3, MPO and PCT levels were significantly lower (p < 0.001, all).

Conclusions: Our findings indicated that the CRP, PTX-3, MPO and PCT levels increase in patients with AP and hence these indicators can be used as diagnostic factors to predict inflammation severity in AP. It was revealed that after treatment, there were significant reductions in biomarker levels. However, further research is needed in order to understand how these biomarkers can help to monitor inflammatory responses in AP.
keywords:

acute pancreatitis, pentraxin-3, procalcitonin, myeloperoxidase

references:
Bhatia M, Brady M, Shokuhi S, Christmas S, Neoptolemos JP, Slavin J. Inflammatory mediators in acute pancreatitis. J Pathol 2000; 190: 117-25.
Bonacina F, Baragetti A, Catapano AL, Norata GD. Long pentraxin 3: experimental and clinical relevance in cardiovascular diseases. Mediators Inflamm 2013; 2013: 725102.
Rayner BS, Love DT, Hawkins CL. Comparative reactivity of myeloperoxidase-derived oxidants with mammalian cells. Free Radic Biol Med 2014; 71: 240-55.
Schuetz P, Albrich W, Mueller B. Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med 2011; 9: 107.
Brunkhorst FM, Eberhard OK, Brunkhorst R. Early identification of biliary pancreatitis with procalcitonin. Am
J Gastroenterol 1998; 93: 1191-2.
Rau B, Steinbach G, Baumgart K, Gansauge F, Grünert A, Beger H. The clinical value of procalcitonin in the prediction of infected necrois in acute pancreatitis. Intensive Care Med 2000; 26: S159-64.
Gurda-Duda A, Kusnierz-Cabala B, Nowak W, Naskalski JW, Kulig J. Assessment of the prognostic value of certain acute-phase proteins and procalcitonin in the prognosis of acute pancreatitis. Pancreas 2008; 37: 449-53.
Bihari D. Monitoring procalcitonin is of value in acute pancreatitis. BMJ 2004; 329: 232.
Mofidi R, Suttie SA, Patil PV, Ogston S, Parks RW. The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis: systematic review. Surgery 2009; 146: 72-81.
Woo SM, Noh MH, Kim BG, et al. Comparison of serum procalcitonin with Ranson, APACHE-II, Glasgow and Balthazar CT severity index scores in predicting severity of acute pancreatitis. Korean J Gastroenterol 2011; 58: 31-7.
Bezmarevic M, Mirkovic D, Soldatovic I, et al. Correlation between procalcitonin and intra-abdominal pressure and their role in prediction of the severity of acute pancreatitis. Pancreatology 2012; 12: 337-43.
Qu R, Ji Y, Ling Y, et al. Procalcitonin is a good tool to guide duration of antibiotic therapy in patients with severe acute pancreatitis. A randomized prospective single-center controlled trial. Saudi Med J 2012; 33: 382-7.
Kim BG, Noh MH, Ryu CH, et al. A comparison of the BISAP score and serum procalcitonin for predicting the severity of acute pancreatitis. Korean J Intern Med 2013; 28: 322-9.
Huang HL, Nie X, Cai B, et al. Procalcitonin levels predict acute kidney injury and prognosis in acute pancreatitis: a prospective study. PLoS One 2013; 8: e82250.
Cai Y, Ee J, Liew YX, et al. A procalcitonin-based guideline promotes shorter duration of antibiotic use safely in acute pancreatitis. J Infect 2014; 69: 412-5.
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62: 102-11.
Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol 2013; 108: 1400-15.
Qu Z, Jiang Y, Wu BQ, Duan YF, Sun ZD, Luo GH. Cystathionine-gamma-lyase inhibitor attenuates acute lung injury induced by acute pancreatitis in rats. Arch Med Sci 2014; 10: 825-9.
Kusnierz-Cabala B, Gurda-Duda A, Dumnicka P, et al. Plasma pentraxin 3 concentrations in patients with acute pancreatitis. Clin Lab 2012; 59: 1003-8.
Meryk P, Dumnicka P, Kuśnierz-Cabala B, et al. [Diagnostic importance of pentraxins at the early phase of acute pancreatitis]. Przegl Lek 2013; 71: 309-13.
Chooklin S. Pathogenic aspects of pulmonary complications in acute pancreatitis patients. Hepatobiliary Pancreat Dis Int 2009; 8: 186-92.
Park BK, Chung JB, Lee JH, et al. Role of oxygen free radicals in patients with acute pancreatitis. World J Gastroenterol 2003; 9: 2266-9.
Lefkowitz D, Mone J, Lefkowitz S. Myeloperoxidase: the good, the bad, and the ugly. Curr Immunol Rev 2010; 6: 123-9.
Modrau IS, Floyd AK, Thorlacius-Ussing O. The clinical value of procalcitonin in early assessment of acute pancreatitis. Am J Gastroenterol 2005; 100: 1593-7.
Rau BM, Kemppainen EA, Gumbs AA, et al. Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT): a prospective international multicenter study. Ann Surg 2007; 245: 745-54.
Staubli SM, Oertli D, Nebiker CA. Laboratory markers predicting severity of acute pancreatitis. Crit Rev Clin Lab Sci 2015; 52: 273-83.
Mándi Y, Farkas G, Takács T, Boda K, Lonovics J. Diagnostic relevance of procalcitonin, IL-6, and sICAM-1 in the prediction of infected necrosis in acute pancreatitis. Int J Pancreatol 2000; 28: 41-9.
Kylänpää-Bäck ML, Takala A, Kemppainen EA, et al. Procalcitonin, soluble interleukin-2 receptor, and soluble E-selectin in predicting the severity of acute pancreatitis. Crit Care Med 2001; 29: 63-9.
d’Eril GM, Merlini G, Finazzi S, Bosoni T, Barakat B, Pezzilli R. Procalcitonin is not a reliable marker for the assessment of severity in acute pancreatitis without infectious complications. Clin Chem 2000; 46: 428-30.
Müller C, Uhl W, Printzen G, et al. Role of procalcitonin and granulocyte colony stimulating factor in the early prediction of infected necrosis in severe acute pancreatitis. Gut 2000; 46: 233-8.
Rau B, Steinbach G, Gansauge F, Mayer J, Grünert A, Beger H. The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis. Gut 1997; 41: 832-40.
Ammori B, Becker K, Kite P, et al. Calcitonin precursors: early markers of gut barrier dysfunction in patients with acute pancreatitis. Pancreas 2003; 27: 239-43.
Ammori B, Becker K, Kite P, et al. Calcitonin precursors in the prediction of severity of acute pancreatitis on the day of admission. Br J Surg 2003; 90: 197-204.
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