Biomarkers in Acute Pancreatitis: Integrating Current Evidence with Pathophysiology and Clinical Practice

Area of Science:

• Gastroenterology and Hepatology
• Biomarker Discovery
• Translational Medicine

Background:

• Acute pancreatitis (AP) presents a spectrum of severity, from mild to life-threatening necrotizing inflammation.
• Early prediction of AP severity and complications is challenging due to limitations of clinical presentation alone.
• Biomarkers are essential for objective diagnosis, severity stratification, and prognosis in AP.

Purpose of the Study:

• To review established and novel biomarkers for acute pancreatitis.
• To evaluate the clinical utility and limitations of current and emerging AP biomarkers.
• To discuss future directions for integrated biomarker strategies in AP patient management.

Main Methods:

• Literature review synthesizing evidence on AP biomarkers.
• Analysis of traditional enzymatic markers (amylase, lipase).
• Evaluation of systemic inflammation markers (cytokines, procalcitonin), acute-phase reactants, and novel omics-based biomarkers (pentraxin-3, microRNAs, proteomics, metabolomics).

Main Results:

• Traditional enzymatic markers lack prognostic value for AP severity.
• Biomarkers of systemic inflammation, immune activation, and infection provide superior prognostic information.
• Novel molecular and omics-based biomarkers offer earlier insights into AP pathophysiology and progression.

Conclusions:

• Biomarkers are critical for improving early risk assessment in acute pancreatitis.
• Emerging biomarkers show promise for enhanced prediction of AP complications and outcomes.
• Integrated biomarker approaches are key for individualized patient management in AP.