Michal Lipinski1, Alicja Rydzewska-Rosolowska2, Andrzej Rydzewski3, Malgorzata Cicha4, Grazyna Rydzewska5. 1. Department of Gastroenterology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland. Electronic address: michal7lipinski@yahoo.com. 2. Department of Nephrology and Transplantation, Medical University of Bialystok, Bialystok, Poland. 3. Department of Internal Medicine and Nephrology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland; The Faculty of Medicine and Health Sciences, UJK, Kielce, Poland. 4. Diagnostic Laboratory, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland. 5. Department of Gastroenterology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland; The Faculty of Medicine and Health Sciences, UJK, Kielce, Poland.
Abstract
BACKGROUND: Soluble urokinase-type plasminogen activator receptor (suPAR) is a glycoprotein secreted during inflammation and infections. Moreover, increased levels of suPAR are observed after hypoxia and ischaemia. The aim of the study was to assess whether suPAR could represent a useful marker of acute pancreatitis (AP) severity. PATIENTS AND METHODS: We have observed a cohort of 126 prospectively enrolled patients. Based on the presence of persistent organ failure (more than 48 h) and local complications (diagnosis of moderate AP [MSAP]), patients were classified into three groups: mild AP (MAP), moderate and severe AP (SAP). The blood samples were taken on admission for detecting suPAR concentrations. RESULTS: AP was considered severe in 33 patients (26.2%), MSAP was found in 37 patients (29.4%), and MAP was found in 56 patients (44,4%). The AUC for SAP predicted by suPAR was 0.993. The calculated cut-off point for prognosis SAP is 4.75 ng/mL. The BISAP score of ≥3 for detection of SAP had sensitivity and specificity of 94.6% and 63.6%, respectively. The AUC for severity predicted by BISAP amounted to 0.916. Additionally, suPAR turned out to be a good predictor of fatal AP: for the cut-off point 7.05 ng/mL, the AUC was 0.917. The AUC for death prediction in AP patients based on the BISAP score ≥3 was 0.894. CONCLUSIONS: suPAR concentration is a promising new diagnostic and prognostic indicator in SAP obtainable in the early stage of disease. Larger studies are recommended to evaluate this role further.
BACKGROUND: Soluble urokinase-type plasminogen activator receptor (suPAR) is a glycoprotein secreted during inflammation and infections. Moreover, increased levels of suPAR are observed after hypoxia and ischaemia. The aim of the study was to assess whether suPAR could represent a useful marker of acute pancreatitis (AP) severity. PATIENTS AND METHODS: We have observed a cohort of 126 prospectively enrolled patients. Based on the presence of persistent organ failure (more than 48 h) and local complications (diagnosis of moderate AP [MSAP]), patients were classified into three groups: mild AP (MAP), moderate and severe AP (SAP). The blood samples were taken on admission for detecting suPAR concentrations. RESULTS: AP was considered severe in 33 patients (26.2%), MSAP was found in 37 patients (29.4%), and MAP was found in 56 patients (44,4%). The AUC for SAP predicted by suPAR was 0.993. The calculated cut-off point for prognosis SAP is 4.75 ng/mL. The BISAP score of ≥3 for detection of SAP had sensitivity and specificity of 94.6% and 63.6%, respectively. The AUC for severity predicted by BISAP amounted to 0.916. Additionally, suPAR turned out to be a good predictor of fatal AP: for the cut-off point 7.05 ng/mL, the AUC was 0.917. The AUC for death prediction in AP patients based on the BISAP score ≥3 was 0.894. CONCLUSIONS:suPAR concentration is a promising new diagnostic and prognostic indicator in SAP obtainable in the early stage of disease. Larger studies are recommended to evaluate this role further.
Authors: Line J H Rasmussen; Steen Ladelund; Thomas H Haupt; Gertrude E Ellekilde; Jesper Eugen-Olsen; Ove Andersen Journal: Crit Care Med Date: 2018-12 Impact factor: 7.598
Authors: Emese Réka Bálint; Gabriella Fűr; Lóránd Kiss; Dávid István Németh; Alexandra Soós; Péter Hegyi; Zsolt Szakács; Benedek Tinusz; Péter Varjú; Áron Vincze; Bálint Erőss; József Czimmer; Zoltán Szepes; Gábor Varga; Zoltán Rakonczay Journal: Sci Rep Date: 2020-10-21 Impact factor: 4.379