Document Detail


Compartmentalization of the inflammatory response during acute pancreatitis: correlation with local and systemic complications.
MedLine Citation:
PMID:  12851244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Local and systemic inflammation has been implicated in the pathogenesis of acute pancreatitis and secondary multisystem organ failure. To assess the pro- and antiinflammatory response, the site of mediator production, and their route of diffusion, we sampled simultaneously ascites, thoracic lymph, and blood at the onset of end-organ dysfunction and for the following 6 days in 60 patients with acute pancreatitis. We used immunoassays to measure pro- and antiinflammatory cytokines and cell-based bioassays to assess the net pro- and antiinflammatory activity elicited by the biological fluids. Tumor necrosis factor-alpha and interleukin-1beta were detected in less than 15% of blood and lymph samples. Secondary pro- and antiinflammatory cytokines were found to be elevated early and throughout the sampling period in all compartments. Cytokine levels decreased from ascites to lymph to blood, suggesting a splanchnic origin. Prolonged diversion of ascites and lymph did not alter cytokine gradients, suggesting mediator transfer via the splanchnic blood circulation. Although a net proinflammatory activity ascribed to interleukin-1beta was detected in ascites, a net antiinflammatory activity was measured in virtually all lymph and blood samples, suggesting that the pancreas and the splanchnic area are sites of a proinflammatory response and that an early, dominant, and sustained antiinflammatory activity takes place in circulating compartments.
Authors:
Thierry L Dugernier; Pierre-Francois Laterre; Xavier Wittebole; Jean Roeseler; Dominique Latinne; Marc S Reynaert; Jérôme Pugin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  168     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-08-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  148-57     Citation Subset:  AIM; IM    
Affiliation:
Department of Intensive Care and Emergency Medicine, St. Luc University Hospital, Hippocrate Avenue, 10 B-1200 Brussels, Belgium. thierry.dugernier@skynet.be
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MeSH Terms
Descriptor/Qualifier:
Ascitic Fluid / metabolism
Biological Assay
Cytokines / metabolism*
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunoenzyme Techniques
Inflammation Mediators / metabolism*
Lymph / metabolism
Male
Middle Aged
Multiple Organ Failure / metabolism*
Pancreatitis, Acute Necrotizing / immunology,  metabolism*
Splanchnic Circulation
Systemic Inflammatory Response Syndrome / immunology,  metabolism*
Chemical
Reg. No./Substance:
0/Cytokines; 0/Inflammation Mediators
Comments/Corrections
Comment In:
Am J Respir Crit Care Med. 2003 Jul 15;168(2):141-2   [PMID:  12851239 ]

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