Anti-inflammatory cytokine response and clinical outcome in acute pancreatitis

• Published in: Critical care medicine Vol. 27; no. 12; pp. 2662 - 2665
• Main Authors: Simovic, Misho O, Bonham, Martin J. D, Abu-Zidan, Fikri M, Windsor, John A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-12-1999; Lippincott
• Subjects: Acute Disease; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Emergency and intensive care: digestive diseases. Bioartificial liver; Female; Humans; Intensive care medicine; Intensive Care Units; Interleukin-10 - blood; Interleukin-6 - blood; Interleukin-8 - blood; Male; Medical sciences; Middle Aged; Multiple Organ Failure - blood; Pancreatitis - classification; Pancreatitis - immunology; Pancreatitis - mortality; Pancreatitis - therapy; Predictive Value of Tests; Severity of Illness Index; Treatment Outcome; Human; Concentration factor; Prognosis; Acute; Cytokine; Pancreatitis; Increase; Blood plasma; Interleukin 6; Interleukin 10; Digestive diseases; Interleukin 8; Pancreatic disease
• ISSN: 0090-3493; 1530-0293
• DOI: 10.1097/00003246-199912000-00009

OBJECTIVE:To test the hypothesis that elevated interleukin (IL)-10 plasma concentration relative to IL-6 and IL-8 in patients with acute pancreatitis is associated with improved clinical outcome.
DESIGN:Case series.
SETTING:University hospital surgical and intensive care unit.
PATIENTS:Patients with mild (n = 18) and severe (n = 14) acute pancreatitis were recruited within 12 hrs of admission and studied for 5 days.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:The plasma concentration of IL-10 was significantly elevated in patients with severe pancreatitis during the 5 days and especially so in those who died compared with survivors on day 5 (p <.03). The ratio of IL-10/IL-6 was decreased in patients with severe pancreatitis on day 5 (p < .01). There was a significant decrease in the ratio of IL-10/IL-8, but not of IL-10/IL-6, during the first 5 days (p < .014).
CONCLUSIONS:The findings are consistent with the hypothesis that an increase in plasma IL-10 relative to IL-6 or IL-8 is associated with improved clinical outcome.