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

Regnér, Sara; Manjer, Jonas; Appelros, Stefan; Hjalmarsson, C; Sadic, Jalal; Borgström, Anders

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

Mark

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)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/1262310

author

Regnér, Sara ^LU

; Manjer, Jonas ^LU ; Appelros, Stefan ^LU ; Hjalmarsson, C ; Sadic, Jalal ^LU and Borgström, Anders ^LU

organization

Surgery (research group)

publishing date

2008

type

Contribution to journal

publication status

published

subject

Surgery

in

Pancreatology

volume

8

issue

6

pages

600 - 607

publisher

Karger

external identifiers

wos:000260494100013
pmid:18849642
scopus:53449099427
pmid:18849642

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

2016-04-04 08:14:42

date last changed

2022-01-29 03:10:40

@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}},
  doi          = {{10.1159/000161011}},
  volume       = {{8}},
  year         = {{2008}},
}

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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.