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Title:
New biomarkers of the severity of acute pancreatitis
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Subject:
uPAR ; organ failure ; acute pancreatiis ; interleukin-6 ; severity
Abstract:
Acute pancreatitis (AP) is one of the most common acute digestive tract diseases. The aim of the study was to evaluate the diagnostic utility of interleukin-6 (IL-6) and serum urokinase-type plasminogen activator receptor (uPAR) measurements for the prediction of the severe course of AP in patients in the early phase of AP..The study included 95 adult patientswith AP treated at the Surgery Unit ,Complex of Health Care Centers in Wadowice Poland .Blood samples were collected on admission and after 48 and 72 hours. Based an the revised Atkanta 2012 classification , 29(30,5%) patients were diagnosed with mild acute pancreatitis(MAP) , 58(61%) with moderately severe acute pancreatitis(MSAP) and 8(8,5%) with severe acute pancreatitis(SAP). IL-6 concentrations in sera were evaluated on admission and on the following day of hospitalization. In patients with SAP , significantly higher IL-6 concentrations were observed on admission when compared with MAP and MSAP group. Moreover, on both days of the study, concentrations of IL-6 correlated with the duration of the hospital stay, Ranson's score, KIM-1 and L-FABP – early markers of acute kidney injury (AKI) – as well as markers of endothelial dysfunction (Ang-2 and sFlt-1). The uPAR concentrations on admission allow for the prognosis of SAP, organ failure (primarily acute kidney injury and acute cardiovascular failure) or the decision to ; transfer the patient to an intensive care unit. Correlations were shown between the serum uPAR and laboratory markers of liver injury such as AST, ALT and bilirubin. The serum uPAR measurements were conducted using the ELISA and until now, uPAR measurements by various methods are not standardized. Despite promising preliminary results, there is no possibility to draw definitive conclusions as for wider uPAR application in SAP prediction. Further studies on a larger group of patients (especially those with SAP) are needed. Meanwhile, however, it must be said that serum uPAR measured in the early phase of the disease does not outperform the routinely conducted and widely acknowledged laboratory tests such as CRP, PCT, or D-dimers in the prediction of the severe course of AP .
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choroby układu trawiennego ; chirurgia