Uncomplicated and Complicated Acute Appendicitis Induce Different Cytokine Patterns.

Area of Science:

• Immunology
• Gastroenterology
• Surgical Pathology

Background:

• Acute appendicitis is a common surgical emergency with unclear immunopathogenesis.
• Distinguishing between uncomplicated and complicated appendicitis is crucial for patient management.

Purpose of the Study:

• To analyze serum cytokine profiles in appendicitis patients.
• To evaluate the diagnostic potential of cytokines in differentiating appendicitis severity.
• To gain insights into the immunopathology of appendicitis.

Main Methods:

• Prospective study analyzing serum samples from 113 patients.
• Measured 48 cytokines using pre-defined subgroup analysis.
• Compared cytokine levels between uncomplicated (72 patients) and complicated (41 patients) appendicitis groups.

Main Results:

• Complicated appendicitis demonstrated significantly elevated levels of interleukin-6 (IL-6), hepatocyte growth factor (HGF), and monocyte chemoattractant protein 1 (MCP-1) compared to uncomplicated cases.
• IL-6 exhibited the highest diagnostic performance (AUC 0.785) for predicting complicated appendicitis.
• Distinct immune responses were observed between the two appendicitis classifications.

Conclusions:

• The immune response differs significantly between complicated and uncomplicated appendicitis, suggesting they represent distinct disease entities.
• Interleukin-6 (IL-6) shows potential as a diagnostic biomarker for complicated appendicitis.