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Protease activation, pancreatic leakage, and inflammation in acute pancreatitis: differences between mild and severe cases and changes over the first three days.

Regnér, Sara LU ; Manjer, Jonas LU ; Appelros, Stefan LU ; Hjalmarsson, C; Sadic, Jalal LU and Borgström, Anders LU (2008) In Pancreatology 8(6). p.600-607
Abstract
BACKGROUND/AIMS: The pathophysiology of acute pancreatitis (AP) may be studied using markers of protease activation (active carboxypeptidase B (aCAP), the activation peptide of carboxypeptidase B (CAPAP)), leakage of pancreatic enzymes (trypsinogen-2, procarboxypeptidase B (proCAP), amylase), and inflammation (monocyte chemoattractant protein-1 (MCP-1), CRP). METHODS: This prospective study included 140 cases of AP. Mild (n = 124) and severe (n = 16) cases were compared with respect to serum levels of trypsinogen-2, proCAP, amylase, aCAP, CAPAP (serum/urine), MCP-1 (serum/urine) and CRP on days 1, 2 and 3 from onset of symptoms. All patients with information on all 3 days were included in a time-course analysis (n = 44-55, except amylase:... (More)
BACKGROUND/AIMS: The pathophysiology of acute pancreatitis (AP) may be studied using markers of protease activation (active carboxypeptidase B (aCAP), the activation peptide of carboxypeptidase B (CAPAP)), leakage of pancreatic enzymes (trypsinogen-2, procarboxypeptidase B (proCAP), amylase), and inflammation (monocyte chemoattractant protein-1 (MCP-1), CRP). METHODS: This prospective study included 140 cases of AP. Mild (n = 124) and severe (n = 16) cases were compared with respect to serum levels of trypsinogen-2, proCAP, amylase, aCAP, CAPAP (serum/urine), MCP-1 (serum/urine) and CRP on days 1, 2 and 3 from onset of symptoms. All patients with information on all 3 days were included in a time-course analysis (n = 44-55, except amylase: n = 27). RESULTS: High levels in severe versus mild cases were seen for trypsinogen-2, CAPAP in serum and urine, and MCP-1 in serum on days 1-3. No differences were seen for proCAP, amylase and aCAP. MCP-1 in urine was significantly elevated on day 1-2, and CRP on day 2-3. CAPAP and MCP-1 levels peaked early and stayed elevated for 48 h in serum. CONCLUSION: Protease activation and inflammation are early events in AP, with high levels of these markers within 24 h. Protease activation declines after 48 h, whereas inflammation is present for a longer time. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pancreatology
volume
8
issue
6
pages
600 - 607
publisher
Karger
external identifiers
  • wos:000260494100013
  • pmid:18849642
  • scopus:53449099427
ISSN
1424-3903
DOI
10.1159/000161011
language
English
LU publication?
yes
id
9b9c2bff-70d8-4350-8ce3-197c26837e01 (old id 1262310)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18849642?dopt=Abstract
date added to LUP
2008-11-05 14:24:00
date last changed
2017-01-01 07:35:39
@article{9b9c2bff-70d8-4350-8ce3-197c26837e01,
  abstract     = {BACKGROUND/AIMS: The pathophysiology of acute pancreatitis (AP) may be studied using markers of protease activation (active carboxypeptidase B (aCAP), the activation peptide of carboxypeptidase B (CAPAP)), leakage of pancreatic enzymes (trypsinogen-2, procarboxypeptidase B (proCAP), amylase), and inflammation (monocyte chemoattractant protein-1 (MCP-1), CRP). METHODS: This prospective study included 140 cases of AP. Mild (n = 124) and severe (n = 16) cases were compared with respect to serum levels of trypsinogen-2, proCAP, amylase, aCAP, CAPAP (serum/urine), MCP-1 (serum/urine) and CRP on days 1, 2 and 3 from onset of symptoms. All patients with information on all 3 days were included in a time-course analysis (n = 44-55, except amylase: n = 27). RESULTS: High levels in severe versus mild cases were seen for trypsinogen-2, CAPAP in serum and urine, and MCP-1 in serum on days 1-3. No differences were seen for proCAP, amylase and aCAP. MCP-1 in urine was significantly elevated on day 1-2, and CRP on day 2-3. CAPAP and MCP-1 levels peaked early and stayed elevated for 48 h in serum. CONCLUSION: Protease activation and inflammation are early events in AP, with high levels of these markers within 24 h. Protease activation declines after 48 h, whereas inflammation is present for a longer time.},
  author       = {Regnér, Sara and Manjer, Jonas and Appelros, Stefan and Hjalmarsson, C and Sadic, Jalal and Borgström, Anders},
  issn         = {1424-3903},
  language     = {eng},
  number       = {6},
  pages        = {600--607},
  publisher    = {Karger},
  series       = {Pancreatology},
  title        = {Protease activation, pancreatic leakage, and inflammation in acute pancreatitis: differences between mild and severe cases and changes over the first three days.},
  url          = {http://dx.doi.org/10.1159/000161011},
  volume       = {8},
  year         = {2008},
}