| Compartmentalization of the inflammatory response during acute pancreatitis: correlation with local and systemic complications. | |
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MedLine Citation:
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PMID: 12851244 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Thierry L Dugernier; Pierre-Francois Laterre; Xavier Wittebole; Jean Roeseler; Dominique Latinne; Marc S Reynaert; Jérôme Pugin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2003-07-09 Completed Date: 2003-08-21 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 148-57 Citation Subset: AIM; IM |
Affiliation:
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Department of Intensive Care and Emergency Medicine, St. Luc University Hospital, Hippocrate Avenue, 10 B-1200 Brussels, Belgium. thierry.dugernier@skynet.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ascitic Fluid
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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:
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0/Cytokines; 0/Inflammation Mediators |
| Comments/Corrections | |
Comment In:
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Am J Respir Crit Care Med. 2003 Jul 15;168(2):141-2
[PMID:
12851239
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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