Wereszczynska-Siemiatkowska U, Dabrowski A, Siemiatkowski A, Mroczko B, Laszewicz W, Gabryelewicz A
Department of Gastroenterology, Medical University of Bialystok, Bialystok, Poland.
Pancreas. 2003 Mar;26(2):144-52. doi: 10.1097/00006676-200303000-00010.
Excessive inflammatory response is one of the major causes of early mortality in acute pancreatitis (AP).
To evaluate the serum profiles of E-selectin, interleukin (IL)-6, and IL-10 along with their correlation to the markers of oxidative stress and neutrophil activation in patients with AP and patients with nonpancreatic acute abdominal pain (NPAAP).
This prospective clinical study included 56 patients with AP (28 with mild AP and 28 with severe AP) as well as 15 patients with NPAAP.
Serum concentrations of E-selectin, IL-10, and IL-6 and plasma concentrations of polymorphonuclear leukocyte elastase (determined on days 1-3, 5, and 10 after admission) were the highest in severe AP during the first 3 days and then declined. At day 10, the E-selectin level in severe AP was still higher than that in mild AP, and the IL-10 concentration increased again. There was no elevation in the E-selectin concentration in NPAAP patients, and IL-10 levels remained unchanged in mild AP. Oxidative stress, measured by serum malondialdehyde and 4-hydroxyalkenals levels, was the most pronounced in severe AP.
The serum E-selectin concentration is markedly elevated in severe AP and is less in mild AP but not in NPAAP. It may result from stimulation with different inflammatory mediators or indicate vascular endothelium injury mediated by oxidative stress, especially in the severe form of AP.
过度的炎症反应是急性胰腺炎(AP)早期死亡的主要原因之一。
评估AP患者和非胰腺性急性腹痛(NPAAP)患者血清中E-选择素、白细胞介素(IL)-6和IL-10水平,以及它们与氧化应激和中性粒细胞活化标志物的相关性。
这项前瞻性临床研究纳入了56例AP患者(28例轻度AP患者和28例重度AP患者)以及15例NPAAP患者。
入院后第1 - 3天、第5天和第10天测定的血清E-选择素、IL-10和IL-6浓度以及血浆多形核白细胞弹性蛋白酶浓度在重度AP患者最初3天最高,随后下降。在第10天,重度AP患者的E-选择素水平仍高于轻度AP患者,且IL-10浓度再次升高。NPAAP患者的E-选择素浓度没有升高,轻度AP患者的IL-10水平保持不变。通过血清丙二醛和4-羟基烯醛水平测量的氧化应激在重度AP中最为明显。
重度AP患者血清E-选择素浓度显著升高,轻度AP患者中该浓度较低,而NPAAP患者中则未升高。这可能是由不同炎症介质刺激引起的,或者表明氧化应激介导的血管内皮损伤,尤其是在重度AP中。