Clinical significance of cytokine alteration in patients with acute pancreatitis

Objective To investigate the serum levels of interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with acute pancreatitis(AP),and to explore the role of cytokines for the assessment of disease severity and prognosis.Methods During Jan.2010 and Jan.2013,58 AP patients,with onset time of AP within 24 h,were enrolled and divided into mild AP(MAP)group(39cases)and severe AP(SAP)group(19cases).Serum levels of TNF-α,IL-1and IL-6were detected at 1,3and 7days after admission.The correlation of cytokines with the acute physiology and chronic health evaluation(APACHEⅡ)score and CT severity index(CTSI)were also analyzed.Results Serum levels of TNF-α,IL-1and IL-6were significantly higher in SAP group than those in MAP group(P0.01).In SAP group,the concentrations of TNF-α,IL-1and IL-6increased slightly in 3days,though there were no statistical differences(P0.05).However,serum levels of TNF-α,IL-1and IL-6at 7days were significantly decreased,compared with the corresponding levels at 1and 3days(P0.01).However,these declined serum levels of selected cytokines were still significantly higher than MAP group.In MAP group,serum levels of TNF-α,IL-1and IL-6decreased gradually and reached significant differences when compared with controls(P0.01).At the 7th day after admission,serum concentrations of TNF-α,IL-1and IL-6almost returned to the baseline.APACHEⅡ score and CTSI of SAP group were significantly higher than MAP group.In MAP group and SAP group,serum levels of IL-1,IL-6and TNF-αwere positively correlated with APACHEⅡ score and CTSI at the 3rd day after admission(P0.01).Conclusion Detection of serum TNF-α,IL-1and IL-6levels could be beneficial fro the assessment of disease severity and prognosis for AP.