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Serum adhesion molecules in acute pancreatitis: time course and early assessment of disease severity
Raffaele Pezzilli1, Massimiliano M Corsi, Alessandra Barassi
1Department of Internal Medicine and Gastroenterology, S Orsola Hospital, Bologna, Italy. raffaele.pezzilli@aosp.bo.it
Insights
Adhesion molecules like E-selectin and P-selectin can help assess acute pancreatitis severity early. A calculated score using these markers shows high accuracy in identifying severe cases.
Area of Science:
- Biochemistry
- Immunology
- Gastroenterology
Background:
- Acute pancreatitis is a serious condition requiring early severity assessment.
- Adhesion molecules play a role in inflammatory processes.
Purpose of the Study:
- To analyze the time course of adhesion molecules in early acute pancreatitis.
- To determine the utility of adhesion molecules in predicting disease severity.
Main Methods:
- Quantified levels of vascular cell adhesion molecule 1, intercellular adhesion molecule 1, E-selectin, P-selectin, and L-selectin.
- Compared adhesion molecule levels between mild and severe acute pancreatitis patients and healthy controls.
Main Results:
- Patients with acute pancreatitis showed altered levels of several adhesion molecules compared to healthy subjects.
- E-selectin was significantly higher in severe acute pancreatitis.
- A multivariate logistic regression score using E-selectin and P-selectin demonstrated high sensitivity and specificity for identifying severe cases.
Conclusions:
- A score combining E-selectin and P-selectin levels shows promise for early acute pancreatitis severity assessment.
- This score could aid in clinical decision-making for patients with acute pancreatitis.
Objectives:
To evaluate the adhesion molecule time course in the early phases of acute pancreatitis and to explore the usefulness of these proteins in assessing the severity of the disease. Fifteen consecutive acute pancreatitis patients (10 patients with the mild and 5 with the severe disease) admitted to the hospital within 6 hours after the onset of pain and 15 age- and sex-matched healthy subjects.
Methods:
Vascular cell adhesion molecule 1, intercellular adhesion molecule 1, E-selectin, P-selectin, and L-selectin were quantified on hospital admission and for the following 2 days.
Results:
Acute pancreatitis patients had vascular cell adhesion molecule 1 and P-selectin concentrations significantly lower and L-selectin concentrations significantly higher than the healthy subjects. Only E-selectin was significantly higher in severe than in mild disease (P = 0.029); a value of E-selectin ranging from 3.83 to 3.92 ng/mL was the best cutoff value for differentiating severe from mild acute pancreatitis (sensitivity: 60.0%, specificity: 90.0%, cases correctly classified: 80%). E-selectin and P-selectin entered the multivariate logistic regression analysis, and a score was calculated showing a sensitivity of 93.3% and a specificity of 86.7% in identifying the patients with severe pancreatitis.
Conclusions:
This score seems to be useful for the early assessment of the severity of acute pancreatitis.
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