Cj. Mckay et al., INCREASED MONOCYTE CYTOKINE PRODUCTION IN ASSOCIATION WITH SYSTEMIC COMPLICATIONS IN ACUTE-PANCREATITIS, British Journal of Surgery, 83(7), 1996, pp. 919-923
Tumour necrosis factor (TNF) alpha, interleukin (IL) 1 beta, IL-6 and
IL-8 are thought to play a central role in the pathophysiology of seps
is but their role in acute pancreatitis is unknown. In the present stu
dy, monocytes were isolated from the peripheral blood of 26 patients w
ith moderate or severe acute pancreatitis without biliary sepsis. Secr
etion of these cytokines in vitro was measured at intervals during the
first week of illness. Sixteen patients developed systemic complicati
ons. Peak TNF-alpha secretion was significantly higher in patients who
developed systemic complications (median (interquartile range (i.q.r.
)) 18.5 (5.5-28.5) ng/ml) than in those with an uncomplicated course (
3.7 (2.3-6.4) ng/ml, P<0.01). Similarly, peak IL-6 and peak IL-8 secre
tion were significantly higher in the complicated group (IL-6: complic
ated median (i.q.r.) 48.9 (12.1-71.0) ng/ml, uncomplicated 16.3 (14.2-
37.9) ng/ml, P<0.05; IL-8: complicated 748 (643-901) ng/ml, uncomplica
ted 608 (496-749) ng/ml), P<0.05). No significant difference in peak I
L-1 beta secretion was observed between the two groups. Systemic compl
ications of acute pancreatitis are associated with a significant incre
ase in monocyte secretion of TNF-alpha, IL-6 and IL-8 suggesting that,
as in sepsis, these cytokines play a central role in the pathophysiol
ogy of the disease.