Jayanta Samanta1, Sukhwinder Singh2, Sunil Arora2, Gaurav Muktesh1, Ashutosh Aggarwal3, Narendra Dhaka1, Saroj Kant Sinha1, Vikas Gupta4, Vishal Sharma1, Rakesh Kochhar5. 1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Immunology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 4. Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 5. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: dr_kochhar@hotmail.com.
Abstract
OBJECTIVES: To study the role of cytokines in prediction of acute lung injury (ALI) in acute pancreatitis. METHODS: Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured in 107 patients at presentation and at 72 h in patients who developed acute lung injury. A model was devised to predict development of ALI using cytokine levels and SIRS score. RESULTS: The levels of TNF α (p < 0.0001), IL-6 (p < 0.0001), IL-8 (p < 0.0001) and IL-1β (p < 0.0001) were significantly higher in the ALI group. IL-10 levels were significantly lower in persistent ALI (p-ALI) than in transient ALI (t-ALI) patients (p < 0.038). p-ALI group had significant rise of TNFα (p = 0.019) and IL-1β (p = 0.001) while t-ALI group had significant rise of only IL-1β (p = 0.044) on day 3 vs day 1. Combined values of IL-6 and IL-8 above 251 pg/ml had sensitivity of 90.9% and a specificity of 100% to predict future development of ALI. Composite marker-I (IL6 ≥ 80 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 98% whereas composite marker-II (IL8 ≥ 100 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 95% to predict future ALI. CONCLUSIONS: IL-6 and IL-8 can predict future development of ALI. When they are combined with SIRS, they can be used as comprehensive composite markers.
OBJECTIVES: To study the role of cytokines in prediction of acute lung injury (ALI) in acute pancreatitis. METHODS: Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured in 107 patients at presentation and at 72 h in patients who developed acute lung injury. A model was devised to predict development of ALI using cytokine levels and SIRS score. RESULTS: The levels of TNF α (p < 0.0001), IL-6 (p < 0.0001), IL-8 (p < 0.0001) and IL-1β (p < 0.0001) were significantly higher in the ALI group. IL-10 levels were significantly lower in persistent ALI (p-ALI) than in transient ALI (t-ALI) patients (p < 0.038). p-ALI group had significant rise of TNFα (p = 0.019) and IL-1β (p = 0.001) while t-ALI group had significant rise of only IL-1β (p = 0.044) on day 3 vs day 1. Combined values of IL-6 and IL-8 above 251 pg/ml had sensitivity of 90.9% and a specificity of 100% to predict future development of ALI. Composite marker-I (IL6 ≥ 80 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 98% whereas composite marker-II (IL8 ≥ 100 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 95% to predict future ALI. CONCLUSIONS:IL-6 and IL-8 can predict future development of ALI. When they are combined with SIRS, they can be used as comprehensive composite markers.
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