Blood concentrations of polymorphonuclear leucocyte elastase and interleukin-6 are indicators for the occurrence of multiple organ failures at the early stage of acute pancreatitis

We studied potential indicators of severe acute pancreatitis by measuring t he blood concentrations of various cytokines, polymorphonuclear leucocyte e lastase (PMN-E), acute phase reactants, pancreatic amylase (P-AMY), pancrea tic elastase-1 (E-1) and white blood cell (WBC) counts in patients with acu te pancreatitis. In addition, the presence of multiple organ damage was ass essed. Subjects consisted of 22 patients with acute pancreatitis including severe (n = 11), moderate (n = 4) and mild (n = 7) cases. A significant pos itive correlation was observed between the number of organs damaged and the peak concentrations of interleukin (IL)-6, PMN-E, C-reactive protein (CRP) and pancreatic secretary trypsin inhibitor (PSTI). Among these markers, bl ood concentrations of PMN-E and IL-6 rapidly increased and peaked at the ea rly phase of acute pancreatitis whereas CRP and PSTI did not. The elevation of PMN-E and IL-6 was greater the more severe the symptoms. However, no si gnificant correlation was observed between the number of organs damaged and the maximum serum concentrations of P-AMY and E-1, or the WBC count, which have been considered to be markers of pancreatitis. These results suggest that PMN-E and IL-6 concentrations are useful indicators of severity and pr ognosis and their determination facilitates the selection of appropriate tr eatment in the early stages of disease to prevent the aggressive progressio n of acute pancreatitis.