[Tumor necrosis factor alpha (TNF-alpha) and its receptors: sTNF-alphaRI i sTNF-alphaRII in chronic pancreatitis]

The exact immunologic mechanisms underlying chronic pancreatitis (CP) are not clearly identified yet. The role of TNF-alpha in CP has been evaluated only rarely. The possible pathogenetic role of the cytotoxic TNF-alpha signal transduction pathway in the clinical course of CP has been recently suggested. The aim of the study was to assess the plasma concentration of TNF-alpha as well as its receptors: sTNF-alpha RI and sTNF-alphaRII in patients with CP of different clinical stage. TNF-alpha, sTNF-alpha RI and sTNF-alpha RII plasma concentrations have been measured with enzyme-linked immunosorbent assay (ELISA) in 39 patients with CP as well as in age- matched healthy volunteers. The percentage of smokers was not different in CP and the control group. The CP stage has been classified according to Cambridge scoring system. The correlation between above mentioned parameters and clinical data, as disease duration and concomitant diabetes has been assessed. The mean TNF-alpha concentration in patients with CP was 24,6 +/- 15,07 pg/ml which was significantly higher (p<0,01) than in control group--11,3 +/- 2,01 pg/ml. The mean values of TNF-alpha receptors concentrations: sTNF-alphaRI and sTNF-alphaRII have also been significantly higher (p<0,01) in patients with CP, compared to controls. No significant differences in TNF-alpha, sTNF-alphaRI, sTNF-alphaRII values dependently on patient alcohol consumption, diabetes and the disease duration have been found. However, the significantly higher TNF-alpha and sTNF-alphaRII concentration (p<0,05) has been observed in patients with Cambridge IV stage compared to patients of all other stages. We conclude that TNF-alpha signal transduction pathway may play a significant role in chronic pancreatitis, particularly of advanced clinical stage.