Serum levels of extracellular matrix in acute pancreatitis

BACKGROUND/AIMS: Elevated levels of serum markers of extracellular matrix, i.e., the amino-terminal procollagen-III-peptide, hyaluronic acid and lamin in are found in various diseases. The study aims to examine a panel of thes e parameters in patients with acute pancreatitis and correlate them with th e course and severity of the disease. METHODOLOGY: We prospectively examined the time-course of procollagen-III-p eptide, hyaluronic acid and laminin in 24 consecutive patients with acute n ecrotizing (n=13) or edematous (n=11) pancresttitis. Patients with chronic pancreatitis with (n=10) or without (n=17) acute pain, and 6 patients in co mplete remission after an episode of acute pancreatitis as well as healthy individuals served as controls. In addition, serum levels of collagen VI an d undulin were followed in 10 and 9 patients with acute necrotizing pancrea titis, respectively. RESULTS: The serum concentrations of procollagen-III-peptide, hyaluronic ac id and laminin were significantly higher at the onset of acute necrotizing pancreatitis compared to edematous pancreatitis and the controls. They retu rned to almost normal levels during the course of the disease when the pati ent recovered, but remained elevated in patients with a lethal course. Lami nin allowed us to discriminate between patients with necrotizing pancreatit is from all other forms of pancreatitis on admission (specificity 82%, sens itivity 92%; PPV 86%, NPV 90%). Collagen type VI levels were 2-3-fold highe r in sera of patients with acute pancreatitis than in healthy controls, whe reas the results for undulin were inconclusive. CONCLUSIONS: Since markers of matrix metabolism (especially laminin) are di fferently elevated in acute necrotizing versus edematous pancreatitis, we s uggest that they might be used as parameters for the outcome.