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Anti-inflammatory cytokine response and clinical outcome in acute pancreatitis

Simovic, Misho O. MD, PhD; Bonham, Martin J. D. MBChB; Abu-Zidan, Fikri M. FRCS, PhD; Windsor, John A. MD, FRACS

Clinical Investigations

Objective: To test the hypothesis that elevated interleukin (IL)-10 plasma concentration relative to IL-6 and IL-8 in patients with acute pancreatitis is associated with improved clinical outcome.

Design: Case series.

Setting: University hospital surgical and intensive care unit.

Patients: Patients with mild (n = 18) and severe (n = 14) acute pancreatitis were recruited within 12 hrs of admission and studied for 5 days.

Interventions: None.

Measurements and Main Results: The plasma concentration of IL-10 was significantly elevated in patients with severe pancreatitis during the 5 days and especially so in those who died compared with survivors on day 5 (p <.03). The ratio of IL-10/IL-6 was decreased in patients with severe pancreatitis on day 5 (p < .01). There was a significant decrease in the ratio of IL-10/IL-8, but not of IL-10/IL-6, during the first 5 days (p < .014).

Conclusions: The findings are consistent with the hypothesis that an increase in plasma IL-10 relative to IL-6 or IL-8 is associated with improved clinical outcome.

From the Pancreatitis Research Group (Drs. Simovic, Bonham, Abu-Zidan, and Windsor), Department of Surgery, Faculty of Medicine and Health Science, University of Auckland, New Zealand.

Supported, in part, by the Health Research Council of New Zealand, the Ruth Spencer Medical Research Fellowship, and the University of Auckland Research Committee. M. Simovic was supported by the Maurice and Phyllis Paykel Trust. F. Abu-Zidan was supported by an Auckland Medical Research Foundation Fellowship.

© 1999 Lippincott Williams & Wilkins, Inc.