Relationship of carotenoid and vitamins A and E with the acute inflammatory response in acute pancreatitis

Background: Inflammation and oxidative stress are believed to be important in the development of the systemic complications of acute pancreatitis. The fat-soluble vitamins A and E, and the carotenoids have antioxidant propert ies. The aim of this study was to assess the effect of acute pancreatitis o n serum concentrations of vitamin antioxidants and to relate such changes t o the degree of the inflammatory response. Methods: Thirteen consecutive patients with predicted severe acute pancreat itis were compared with 26 matched healthy controls. Five patients develope d severe acute pancreatitis and three of these died. Vitamin antioxidant an d C-reactive protein (CRP) levels were measured daily for up to 7 days. Results: Patients had significantly lower levels of antioxidants throughout the course of the study (P<0.017). In patients there was a significant cor relation between peak CRP and trough antioxidant levels (P < 0.01). In pati ents with mild acute pancreatitis, the concentrations of retinol and beta-c arotene at final review were significantly higher than those in patients wi th severe acute pancreatitis (P<0.05). This coincided with a reduction in C RP level. Conclusion: In acute pancreatitis, circulating concentrations of vitamin an tioxidants are reduced and are inversely related to the rise in CRP level.