Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2013, vol. 22, nr 3, May-June, p. 361–368

Publication type: original article

Language: English

Plasma Endothelin-1 Levels in Pancreatic Inflammations

Stężenie endotheliny-1 w osoczu w zapaleniach trzustki

Stanisław Milnerowicz1,C,D,E, Halina Milnerowicz2,A, Stanisław Nabzdyk1,B, Monika Jabłonowska2,A, Krzysztof Grabowski1,F, Renata Taboła1,B

1 Department and clinic of Gastrointestinal and General Surgery, Wroclaw Medical University, Wrocław, Poland

2 Department of Biomedical and environmental analyses, Wroclaw Medical University, Wrocław, Poland

Abstract

Background. In inflammatory processes endothelin exerts an important effect on the pancreatic blood vessels and disturbances in pancreatic microcirculation.
Objectives. The aim of the study was to evaluate the usefulness of plasma endothelin-1 (eT-1) levels in determining the severity of pancreatitis, its prognosis and monitoring the course of therapy.
Material and Methods. The investigations were carried out on 115 subjects: 85 patients with pancreatitis and 30 persons serving as a control group. all the participants’ eT-1 levels were determined by means of an enzymoimmunological test (endothelin eTa Kit, catalog No:583151, cayman chemical company, Michigan, USa) on the 1st, 3rd, 5th and 7th days of treatment. In the control group, the mean eT-1 level was 1.37 pg/ml.
Results. acute pancreatitis (aP) was diagnosed in 53 patients, including 36 patients (67.9%) with severe aP. Their Ranson’s scores were over 3 points. The highest mean plasma eT-1 levels were observed in 10 patients with severe aP with necrosis (6.37 ± 1.9 pg/ml). (5 to 9 points on Ranson’s scale). In 26 patients with severe aP without necrosis, the mean plasma eT-1 level was 3.49 ± 1.24 pg/ml. In 17 patients with mild aP the mean plasma eT-1 level was 3.48 ± 1.16 pg/ml (3 to 4 points on Ranson’s scale). eT-1 levels normalized gradually with successful treatment. an increase in eT-1 levels between the 5th and 7th days was an unfavorable prognostic factor that was observed in all the patients who died.
Conclusion. Measuring plasma eT-1 levels permits early determination of cases with severe aP. eT-1 can be used as a marker for both the progress of the disease and the efficacy of the treatment. an increase in plasma eT-1 level between the 5th and 7th days of treatment may indicate irreversible ischemic lesions in the pancreas and the development of necrotic lesions.

Streszczenie

Wprowadzenie.W stanach zapalnych trzustki endotelina wywiera bardzo duży wpływ na przepływ krwi przez naczynia trzustkowe i zaburzenia mikrokrążenia trzustkowego.
Cel pracy. celem przeprowadzonych badań była ocena przydatności oznaczania stężenia endoteliny-1 (eT-1) w osoczu do określania zaawansowania zmian zapalnych trzustki oraz prognozowania i monitorowania przebiegu leczenia.
Materiał i metody. . Badania wykonano u 115 osób: 85 chorych z zapaleniem trzustki i 30 osób w grupie kontrolnej. U wszystkich oznaczano stężenia eT-1 w surowicy testem enzymoimmunologicznym – endothelin-1 eTa (endothelin eTa Kit, catalog No:583151, cayman chemical company, Michigan, USa), w 1., 3., 5. i 7. dniu leczenia. Średni poziom stężenia eT-1 w osoczu w grupie kontrolnej – 1,37 pg/ml.
Wyniki. Ostre zapalenie trzustki (OZT) rozpoznano u 53 chorych, w tym u 36 chorych (67,9%) stwierdzono ciężką postać OZT. W skali Ransona oceniono ich powyżej 3 pkt. Najwyższy przeciętny poziom stężenia eT-1 w osoczu obserwowano u 10 chorych na ciężką postać OZT z martwicą (6,37 ± 1,9 pg/ml) (w skali Ransona 5–9 pkt.). U 26 chorych na ciężką postać OZT bez martwicy przeciętny poziom stężenia eT-1 w osoczu wynosił 3,49 ± 1,24 pg/ ml; a u 17 chorych na łagodną postać OZT przeciętny poziom stężenia eT-1 w osoczu wynosił 3,48 ± 1,16 pg/ml (w skali Ransona 3–4 pkt.). Przy pomyślnym leczeniu stężenie endoteliny-1 stopniowo wracało do wartości prawidłowych. Wzrost poziomu stężenia endoteliny-1 w osoczu między 5. a 7. dniem był niekorzystnym wskaźnikiem prognostycznym obserwowanym u wszystkich chorych, którzy zmarli.
Wnioski. Oznaczanie poziomu stężenia endoteliny-1 w osoczu umożliwia wczesne rozpoznanie przypadków z ciężką postacią ostrego zapalenia trzustki. eT-1 może być markerem diagnostycznym, prognostycznym i monitorującym skuteczność leczenia. Wzrost poziomu stężenia endoteliny-1 w osoczu między 5. a 7. dniem leczenia może wskazywać na narastanie nieodwracalnych, niedokrwiennych zmian w trzustce i rozwijania się martwicy trzustki.

Key words

pancreatitis, endothelin-1, monitoring of treatment.

Słowa kluczowe

zapalenie trzustki, endotelina-1, monitorowanie leczenia.

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