Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Immunology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Pancreatology. 2018 Dec;18(8):878-884. doi: 10.1016/j.pan.2018.10.006. Epub 2018 Oct 18.
To study the role of cytokines in prediction of acute lung injury (ALI) in acute pancreatitis.
Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured in 107 patients at presentation and at 72 h in patients who developed acute lung injury. A model was devised to predict development of ALI using cytokine levels and SIRS score.
The levels of TNF α (p < 0.0001), IL-6 (p < 0.0001), IL-8 (p < 0.0001) and IL-1β (p < 0.0001) were significantly higher in the ALI group. IL-10 levels were significantly lower in persistent ALI (p-ALI) than in transient ALI (t-ALI) patients (p < 0.038). p-ALI group had significant rise of TNFα (p = 0.019) and IL-1β (p = 0.001) while t-ALI group had significant rise of only IL-1β (p = 0.044) on day 3 vs day 1. Combined values of IL-6 and IL-8 above 251 pg/ml had sensitivity of 90.9% and a specificity of 100% to predict future development of ALI. Composite marker-I (IL6 ≥ 80 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 98% whereas composite marker-II (IL8 ≥ 100 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 95% to predict future ALI.
IL-6 and IL-8 can predict future development of ALI. When they are combined with SIRS, they can be used as comprehensive composite markers.
研究细胞因子在预测急性胰腺炎并发急性肺损伤（ALI）中的作用。
检测 107 例急性胰腺炎患者入院时及发生 ALI 后 72 小时的 TNFα、IL-6、IL-10、IL-8 和 IL-1β 水平。设计了一种使用细胞因子水平和 SIRS 评分预测 ALI 发生的模型。
ALI 组 TNFα（p<0.0001）、IL-6（p<0.0001）、IL-8（p<0.0001）和 IL-1β（p<0.0001）水平明显升高。持续 ALI（p-ALI）患者的 IL-10 水平明显低于短暂性 ALI（t-ALI）患者（p<0.038）。p-ALI 组 TNFα（p=0.019）和 IL-1β（p=0.001）在第 3 天较第 1 天显著升高，而 t-ALI 组仅 IL-1β（p=0.044）显著升高。IL-6 和 IL-8 的联合值超过 251pg/ml 时，预测 ALI 发生的敏感性为 90.9%，特异性为 100%。复合标志物 I（IL6≥80pg/ml+SIRS）的敏感性和特异性分别为 73%和 98%，而复合标志物 II（IL8≥100pg/ml+SIRS）的敏感性和特异性分别为 73%和 95%，可预测未来 ALI 的发生。
IL-6 和 IL-8 可预测未来 ALI 的发生。当与 SIRS 结合使用时，它们可作为综合复合标志物。
