PMID- 12589535 OWN - NLM STAT- MEDLINE DCOM- 20031002 LR - 20181113 IS - 0342-4642 (Print) IS - 0342-4642 (Linking) VI - 29 IP - 4 DP - 2003 Apr TI - CC-chemokine activation in acute pancreatitis: enhanced release of monocyte chemoattractant protein-1 in patients with local and systemic complications. PG - 622-9 AB - OBJECTIVE: Systemic leukocyte activation is claimed to trigger inflammatory response and remote organ dysfunction in acute pancreatitis. Chemokines are inflammatory mediators with potent leukocyte-activating properties and have been shown to be involved in the pathophysiological process of experimental acute pancreatitis. However, as little is known about their role in human disease we investigated local and systemic concentrations of different CC-chemokine members in patients with acute pancreatitis. PATIENTS AND METHODS: We included 68 patients with acute pancreatitis in the present study. Local complications in terms of necrosis were present in 37 (54%) patients of whom 21 (57%) developed pancreatic infections. Monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1alpha (MIP-1alpha) and macrophage inflammatory protein-1beta (MIP-1beta) concentrations were measured daily over 2 weeks after study inclusion by ELISA in sera and lesser sac aspirates. RESULTS: MCP-1 serum concentrations showed a dramatic increase in patients who developed local complications and/or remote organ failure. Herein, a close correlation was found between the severity of remote organ failure and the degree of MCP-1 elevation. Multiple regression analysis identified pancreatic infections as well as renal and cardiocirculatory failure as independent variables associated with enhanced systemic MCP-1 release. MIP-1alpha levels remained unaffected by local complications and showed a significant increase only; if multiple organ dysfunction syndrome (MODS) developed or patients subsequently died. In contrast, MIP-1beta concentrations correlated with neither the presence nor the severity of any complication. Compared with systemic concentrations, local lesser sac aspirates revealed significantly higher levels of MCP-1, whereas MIP-1alpha and MIP-1beta were not different. CONCLUSIONS: Complicated acute pancreatitis is associated with significantly elevated local and systemic concentrations of the CC-chemokine MCP-1. Our results suggest that, among the CC-chemokine members investigated, MCP-1 might play a pivotal role in the pathological mechanism of complicated acute pancreatitis. FAU - Rau, Bettina AU - Rau B AD - Department of General, Visceral and Vascular Surgery, University of the Saarland, Kirrberger Strasse, 66421, Homburg / Saar, Germany. bettina.rau@uniklinik-saarland.de FAU - Baumgart, Katja AU - Baumgart K FAU - Kruger, Colin M AU - Kruger CM FAU - Schilling, Martin AU - Schilling M FAU - Beger, Hans G AU - Beger HG LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20030215 PL - United States TA - Intensive Care Med JT - Intensive care medicine JID - 7704851 RN - 0 (Chemokine CCL2) RN - 0 (Chemokine CCL3) RN - 0 (Chemokine CCL4) RN - 0 (Macrophage Inflammatory Proteins) SB - IM MH - Acute Disease MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Chemokine CCL2/*biosynthesis MH - Chemokine CCL3 MH - Chemokine CCL4 MH - Child MH - Enzyme-Linked Immunosorbent Assay MH - Female MH - Humans MH - Macrophage Inflammatory Proteins/*biosynthesis MH - Male MH - Middle Aged MH - Multiple Organ Failure/metabolism MH - Necrosis MH - Pancreatitis/complications/*metabolism MH - ROC Curve MH - Regression Analysis MH - Risk Factors MH - Statistics, Nonparametric EDAT- 2003/02/18 04:00 MHDA- 2003/10/03 05:00 CRDT- 2003/02/18 04:00 PHST- 2002/05/27 00:00 [received] PHST- 2003/01/10 00:00 [accepted] PHST- 2003/02/18 04:00 [pubmed] PHST- 2003/10/03 05:00 [medline] PHST- 2003/02/18 04:00 [entrez] AID - 10.1007/s00134-003-1668-4 [doi] PST - ppublish SO - Intensive Care Med. 2003 Apr;29(4):622-9. doi: 10.1007/s00134-003-1668-4. Epub 2003 Feb 15.