Reduction in circulating levels of CD4-positive lymphocytes in acute pancreatitis: Relationship to endotoxin, interleukin 6 and disease severity

1993 ◽  
Vol 80 (10) ◽  
pp. 1312-1315 ◽  
Author(s):  
P. J. Curley ◽  
M. J. McMahon ◽  
F. Lancaster ◽  
R. E. Banks ◽  
G. R. Barclay ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Disease Severity ◽  
Interleukin 6 ◽  
Circulating Levels

scholarly journals Effects of the peripherally acting μ-opioid receptor antagonist methylnaltrexone on acute pancreatitis severity: study protocol for a multicentre double-blind randomised placebo-controlled interventional trial, the PAMORA-AP trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Cecilie Siggaard Knoph ◽  
Mathias Ellgaard Cook ◽  
Camilla Ann Fjelsted ◽  
Srdan Novovic ◽  
Michael Bau Mortensen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Receptor Antagonist ◽  
Disease Severity ◽  
Opioid Receptor ◽  
Double Blind ◽  
Interventional Trial ◽  
Opioid Receptor Antagonist ◽  
Link Type ◽  
Μ Opioid Receptor ◽  
Circulating Levels

Abstract Background Moderate to severe acute pancreatitis (AP) is associated with a high rate of complications and increased mortality, yet no targeted pharmacologic treatment currently exists. As pain is a dominant symptom in AP, patients are exposed to excess levels of both endo- and exogenous opioids, which may have harmful effects on the course of AP. This trial investigates the effects of the peripherally acting μ-opioid receptor antagonist (PAMORA) methylnaltrexone on disease severity and clinical outcomes in patients with moderate to severe AP. Methods PAMORA-AP is a multicentre, investigator-initiated, double-blind, randomised, placebo-controlled, interventional trial, which will be conducted at four referral centres for acute pancreatitis in Denmark. Ninety patients with early-onset AP (pain onset within 48 h) as well as predicted moderate to severe disease (two or more systemic inflammatory response syndrome criteria upon admission) will be prospectively included. Subsequently, participants will be randomised (1:1) to intravenous treatment with either methylnaltrexone or matching placebo (Ringer’s lactate) during 5 days of admission. The primary endpoint will be the group difference in disease severity as defined and measured by the Pancreatitis Activity Scoring System (PASS) score 48 h after randomisation. Secondary endpoints include daily PASS scores; disease severity according to the Atlanta classification; quantification of need for analgesics, nutritional support, intravenous fluid resuscitation and antibiotics; duration of hospital admissions, readmission rates and mortality. Pain intensity and gut function will be self-reported using validated questionnaires. Exploratory endpoints include circulating levels of pro-and anti-inflammatory markers, polyethylene glycol recovery from the urine, circulating levels of blood markers of intestinal permeability, the prevalence of pancreatic complications on computed tomography (CT) scans, and colon transit time assessed using a CT-based radiopaque marker method. Discussion This trial aims to evaluate the PAMORA methylnaltrexone as a novel targeted pharmacotherapy in patients with moderate to severe AP with the potential benefit of improved patient outcomes. Trial registration ClinicalTrials.govNCT04743570. Registered on 28 January 2021. EudraCT 2020-002313-18.

scholarly journals Effects of The Peripherally Acting µ-Opioid Receptor Antagonist Methylnaltrexone On Acute Pancreatitis Severity: Study Protocol for a Multicentre Double-Blind Randomised Placebo-Controlled Interventional Trial, The PAMORA-AP Trial

2021 ◽  
Author(s):  
Cecilie Siggaard Knoph ◽  
Mathias Ellgaard Cook ◽  
Camilla Ann Fjelsted ◽  
Srdan Novovic ◽  
Michael Bau Mortensen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Receptor Antagonist ◽  
Disease Severity ◽  
Opioid Receptor ◽  
Hospital Admissions ◽  
High Rate ◽  
Double Blind ◽  
Interventional Trial ◽  
Opioid Receptor Antagonist ◽  
Circulating Levels

Abstract Background: Moderate to severe acute pancreatitis (AP) is associated with a high rate of complications and increased mortality, yet no targeted pharmacologic treatment currently exists. As pain is a dominant symptom in AP, patients are exposed to excess levels of both endo- and exogenous opioids, which may have harmful effects on the course of AP. This trial investigates the effects of the peripherally acting µ-opioid receptor antagonist (PAMORA) methylnaltrexone on disease severity and clinical outcomes in patients with moderate to severe AP. Methods: PAMORA-AP is a multicentre, investigator-initiated, double-blind, randomised, placebo-controlled, interventional trial, which will be conducted at four referral centres for acute pancreatitis in Denmark. Ninety patients with early-onset AP (pain onset within 48 hours) as well as predicted moderate to severe disease (two or more systemic inflammatory response syndrome criteria upon admission) will be prospectively included. Subsequently, participants will be randomised (1:1) to intravenous treatment with either methylnaltrexone or matching placebo (Ringer’s lactate) during 5 days of admission. The primary endpoint will be the group difference in disease severity as defined and measured by the Pancreatitis Activity Scoring System (PASS) score 48 hours after randomisation. Secondary endpoints include daily PASS scores; disease severity according to the Atlanta classification; quantification of need for analgesics, nutritional support, intravenous fluid resuscitation and antibiotics; duration of hospital admissions, readmission rates and mortality. Pain intensity and gut function will be self-reported using validated questionnaires. Exploratory endpoints include circulating levels of pro-and anti-inflammatory markers, polyethylene glycol recovery from the urine, circulating levels of blood markers of intestinal permeability, the prevalence of pancreatic complications on computed tomography (CT) scans, and colon transit time assessed using a CT-based radiopaque marker method. Discussion: This trial aims to evaluate the PAMORA methylnaltrexone as a novel targeted pharmacotherapy in patients with moderate to severe AP with the potential benefit of improved patient outcomes.Trial registration: ClinicalTrials.gov, Identifier: NCT04743570. Registered 28 January 2021, https://clinicaltrials.gov/ct2/show/NCT04743570. EudraCT, Identifier: 2020-002313-18.

scholarly journals Chemokine receptor 8 expression may be linked to disease severity and elevated interleukin 6 secretion in acute pancreatitis

2021 ◽  
Vol 12 (6) ◽  
pp. 115-129
Author(s):  
Mwangala Nalisa ◽  
Ekene Emmanuel Nweke ◽  
Martin D Smith ◽  
Jones Omoshoro-Jones ◽  
John WS Devar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Disease Severity ◽  
Chemokine Receptor ◽  
Interleukin 6

Interleukin-6 is associated with obesity, central fat distribution, and disease severity in patients with acute pancreatitis

Pancreatology ◽  
2015 ◽  
Vol 15 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Jongwon Park ◽  
Jae Hyuck Chang ◽  
Sang Hi Park ◽  
Hee Jin Lee ◽  
Yeon Soo Lim ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Disease Severity ◽  
Interleukin 6 ◽  
Fat Distribution ◽  
Central Fat

INTERLEUKIN 6 AND CRP IN THE PREDICTION THE SEVERITY IN PATIENTS OF ACUTE PANCREATITIS

2015 ◽  
pp. 29-35
Author(s):  
Van Xung Nguyen ◽  
Van Huy Tran
Keyword(s):  
Acute Pancreatitis ◽  
Key Words ◽  
Interleukin 6 ◽  
Accuracy Rate ◽  
Background Data ◽  
Single Marker ◽  
Key Words Interleukin 6

Background: Data about the value of interleukin 6 and CRP in the prediction of severity of acute pancreatitis (AP) is still limited. This study is aimed at assessing the values of interleukin 6 and CRP in the prediction the severity of AP. Patients and methods: 55 patients with AP were enrolled. Interleukin was measured at 2 times: the 1st and the 3rd days. Results: IL-6 level day 1 in severe AP (168.86 ± 70.65 pg/ml) was significantly higher than in mild AP (89.54 ± 28.81 pg/ml) and IL-6 day 3 in severe AP (58.64 ± 20.77 pg/ml) significantly higher than mild AP (29.73 ± 14.88 pg/ml). concerning the prediction of severity of AP, IL-6 in day 1 (with cut-off 113.36 pg/ml) had the sensitivity 81.25% and the specificity 84.64%, PPV 68.4% and NPV 91.7%, accuracy rate 88.8%, AUC 0.888 and respectively in day 3 (with cut-off 41.38 pg/ml were 87.5%; 87.18%; 73.7%; 4.4%; 86.7%; 0.867. The values in prediction of severity were significantly higher when combining IL 6 and CRP in compare with the single marker. Conclusion: Combining Interleukin 6 and CRP may have a good value in the prediction of the severity of AP. Key words: Interleukin 6, CRP, acute pancreatitis, severity.

Pleuropulmonary pathologies in the early phase of acute pancreatitis correlate with disease severity

Pancreatology ◽  
2021 ◽  
Vol 21 ◽  
pp. S30
Author(s):  
I. Luiken ◽  
S. Eisenmann ◽  
J. Garbe ◽  
J. Dober ◽  
W.A. Wohlgemuth ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Disease Severity ◽  
Early Phase

scholarly journals The Association of Circulating MiR-29b and Interleukin-6 with Subclinical Atherosclerosis

2017 ◽  
Vol 44 (4) ◽  
pp. 1537-1544 ◽  
Author(s):  
Yu-qing Huang ◽  
Jie Li ◽  
Ji-yan Chen ◽  
Ying-ling Zhou ◽  
An-ping Cai ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Interleukin 6 ◽  
Subclinical Atherosclerosis ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Control Group ◽  
Study Group ◽  
Circulating Levels

Background/Aims: Although it is widely acknowledged that atherosclerosis is mainly a chronic inflammatory process, in which both miR-29b and interleukin-6 (IL-6) play multifaceted roles, the association between miR-29b and IL-6 remains unknown. The aim of the present study was to explore the relationship between miR-29b and IL-6 and to test whether circulating levels of miR-29b and IL-6 could predict atherosclerosis. Methods: A total of 170 participants were divided into two groups according to carotid intima-media thickness (CIMT): study group (CIMT ≥ 0.9mm) and control group (CIMT < 0.9mm). Levels of circulating miR-29b and IL-6 were measured by quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The association of miR-29b and IL-6 levels with CIMT was assessed using Spearman correlation analysis and multiple linear regression analysis. Results: The study group showed higher miR-29b levels (31.61 ± 3.05 vs. 27.91 ± 1.71 Ct, p < 0.001) and IL-6 levels (3.40 ± 0.67 vs. 2.99 ± 0.37 pg/ml, p < 0.001), compared with the control group. CIMT was positively correlated with miR-29b (r = 0.587, p < 0.001) and IL-6 (r = 0.410, p < 0.001), and miR-29b levels were also correlated with IL-6 (r = 0.242, p = 0.001). Multiple linear regression analysis also showed that CIMT was positively correlated with miR-29b and IL-6. After adjustment for age, body mass index, systolic blood pressure, total cholesterol and C-reactive protein, CIMT was still closely correlated with miR-29b and IL-6. The combination of miR-29b and IL-6 (AUC = 0.901, p < 0.001) offered a better predictive index for atherosclerosis than either miR-29b (AUC = 0.867, p < 0.001) or IL-6 (AUC = 0.747, p < 0.001) alone. Conclusion: Circulating levels of miR-29b and IL-6 may be independently correlated with subclinical atherosclerosis, and may serve as novel biomarkers for the identification of atherosclerosis.

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