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Anti-inflammatory cytokine response and clinical outcome in acute pancreatitis
M O Simovic1, M J Bonham, F M Abu-Zidan
1Pancreatitis Research Group, Department of Surgery, Faculty of Medicine and Health Science, University of Auckland, New Zealand.
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.