Diagnostic value of inflammatory markers in patients with acute pancreatitis

Abstract

Introduction: Acute pancreatitis (AP) is a sudden inflammatory reaction that causes autodigestion of the pancreas, edema, bleeding, and can lead to pancreatic necrosis and necrosis of the surrounding tissue. Since the initial symptoms of mild, moderate and severe pancreatitis are the same, doctors often cannot determine the severity of AP with certainty based on the first examination. Aim of the work: Numerous biomarkers have been studied as potential early predictors of the severity of this disease, so that treatment can be optimally adapted to prevent complications. The aim of the paper is to provide an overview of the most important inflammatory markers that are used, or can potentially be used to determine the severity of acute pancreatitis. Inflammatory markers: Markers of inflammation in AP are: the hormone procalcitonin, then reactants of the acute phase such as C-reactive protein, serum amyloid A, pentraxin 3; enzymes: polymorphonuclear elastase, phospholipase A2, myeloperoxidase; cytokines: interleukins (IL-6, IL-8, IL-17) and tumor necrosis factor (TNF-a). Conclusion: The most frequently determined parameter in clinical practice is CRP, as a non-specific marker of inflammatory diseases. The disadvantage in determining this parameter is that the maximum serum value is reached only 72 hours after the onset of AP symptoms. Numerous biomarkers have proven to be more sensitive for determining the severity of AP, of which procalcitonin stands out, which has been widely used in recent years, for the early prognosis of the development of local complications and multiorgan failure in AP. Cytokine determination is increasingly part of clinical practice. The most commonly used IL-6 is a sensitive and specific marker for predicting organ failure in severe AP