Interleukin 1 receptor antagonist and E-selectin concentrations: A comparison in patients with severe acute pancreatitis and severe sepsis

Purpose: This prospective clinical study was designed to compare interleuki n 1 receptor antagonist (IL-1ra) and E-selectin concentrations in patients with severe acute pancreatitis to those with severe sepsis. Materials and Methods: Nine consecutive patients with severe acute pancreat itis and 11 consecutive patients with severe sepsis admitted to a medical/s urgical intensive care unit were included in the study. Plasma concentratio ns of IL-1ra and E-selectin were serially measured daily for 7 days or thro ughout their stay in the intensive care unit if shorter. Results: The concentrations of IL-1ra were significantly higher on admissio n in patients with severe sepsis compared with the patients with severe pan creatitis (median levels 10,500 and 2,600 pg/mL, respectively, P =.007). Wh en the data from the first 3 days were analyzed using analysis of variance (ANOVA), the levels of IL-1ra and E-selectin were similar in both groups. T he concentrations of IL-1ra and E-selectin correlated to the development of multiorgan dysfunction as assessed by sequential organ failure assessment (SOFA) score (P = .032 and .043, respectively). Conclusion: This study shows th at IL-1ra a nd E-selectin are released in a cute severe pancreatitis, and the levels seem to be comparable to those in patients with severe sepsis. Concentrations of IL-1ra and E-selectin correl ate to the development of multiorgan failure as indicated by high SOFA scor es during the first week of disease. Copyright (C) 1999 by W.B. Saunders Co mpany.