Relationship between plasma cytokine concentration and multiple organ failure in patients with acute pancreatitis

The dynamic aspects of circulating cytokines and cytokine modulators and th eir relationship with development of multiple organ failure (MOF) in patien ts with acute pancreatitis were analyzed. All cytokine and C-reactive prote in levels in the circulation were higher than those in the MOF group. In pa rticular, plasma concentrations of soluble tumor necrosis factor receptors (sTNF-RI and sTNF-RII) were significantly higher in patients with MOF than in those without even at admission. Furthermore, plasma concentrations of s TNF-Rs and interleukin-1 (IL-1) receptor antagonist (IL-1ra) were much high er than those of their counterparts, TNF-alpha and IL-1 beta, respectively. These results suggest that the plasma concentrations of sTNF-Rs are useful predictors for the development of MOF, and actions of TNF-alpha and IL-1 b eta could be regulated by their modulators (soluble receptor and receptor a ntagonist, respectively) in the pathologic condition of severe acute pancre atitis.