Review Article Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis
Citations
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Citation Context ... hepatocytes and G-cells of the thyroid gland [56]. It is an acute phase reactant that has been extensively investigated as earlymarker in systemic bacterial infection, sepsis, and multiorgan failure =-=[68]-=-. Because severe acute pancreatitis is associated with sepsis, infected pancreatic necrosis, and multiorgan failure, procalcitonin can be used as a useful marker in early prediction of severity [69]. ... |
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Citation Context ...of AP over the last few decades, although the case fatality rate has remained unchanged [7]. This may either be due to increased incidence of gallstone disease or improvement in diagnostic modalities =-=[8]-=-. The revised Atlanta classification system has classified AP into mild, moderate, and severe [9, 10]. More than 80% of acute pancreatitis attacks are mild and self-limiting and resolve without seriou... |
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Citation Context ... but reaches up to 30%–40% in patients with severe disease [13, 14]. Sepsis related multiorgan failure and infected pancreatic necrosis account for about 40–50% of all mortality in acute pancreatitis =-=[13, 15, 16]-=-. Mortality in AP occurs in two peaks [17–21]. Nearly 50% of deaths occur early within the first week due tomassive inflammatory responses leading to multiorgan failure. Septic complications related t... |
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Inflammatory mediators in acute pancreatitis.
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Citation Context ...rypsin in pancreatic parenchyma acting as the central step in the initiation of autodigestion of pancreatic tissue and subsequent local and systemic inflammation is presently the most accepted theory =-=[17, 18, 30, 31]-=-. Whatever is the initiating event, the disease progression can be viewed as a threephase continuum: local inflammation of the pancreas and a generalized inflammatory response followed by the final st... |
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Citation Context ...rypsin in pancreatic parenchyma acting as the central step in the initiation of autodigestion of pancreatic tissue and subsequent local and systemic inflammation is presently the most accepted theory =-=[17, 18, 30, 31]-=-. Whatever is the initiating event, the disease progression can be viewed as a threephase continuum: local inflammation of the pancreas and a generalized inflammatory response followed by the final st... |
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Citation Context ...thereby reducing the financial implications. 5. Role of Biomarkers in Prediction of Severe Acute Pancreatitis Severity assessment in acute pancreatitis was first started in 1974 by late Ranson et al. =-=[54]-=-. Since then a number of multifactorial scoring systems using common clinical and biochemical parameters have been described for prediction of severity. Ranson, Glasgow, andAPACHE II score are few of ... |
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Citation Context ...related to infected pancreatic necrosis leading to multiorgan failure are the prime cause of death, late in the disease [17– 21]. The course and severity of AP can fluctuate rapidly and unpredictably =-=[1, 22]-=-. Despite the advances in investigational modalities and research techniques, the exact pathogenesis of AP is still unclear [18, 23–25]. Recent studies have suggested the role of inflammatorymediators... |
14 |
The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis: Systematic review. Surgery,
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Citation Context ... and specificity of PCT for development of SAP were 73% and 87%, respectively, and overall area under curve (AUC) was 0.88. However, there was significant heterogeneity among individuals in the study =-=[73]-=-. In their study, Khanna et al. found 100% sensitivity of procalcitonin for prediction of organ failure andmortality, with a sensitivity of 86.4% for prediction of SAP [56]. Like that of Interleukin6,... |
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Inflammatory mediators as therapeutic targets in acute pancreatitis.
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Citation Context ...rypsin in pancreatic parenchyma acting as the central step in the initiation of autodigestion of pancreatic tissue and subsequent local and systemic inflammation is presently the most accepted theory =-=[17, 18, 30, 31]-=-. Whatever is the initiating event, the disease progression can be viewed as a threephase continuum: local inflammation of the pancreas and a generalized inflammatory response followed by the final st... |
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Citation Context ...y Stratification and Its Assessment Acute pancreatitis is self-limiting in 75%–80% of cases and does not require any treatment other than parenteral intravenous fluid, analgesics, and supportive care =-=[4, 22, 23]-=-. The remaining may suffer from severe attacks, with the mortality reaching up to 30%–50% [18]. This subgroup of patients needs to be identified early in the course of the disease and needs to be aggr... |
9 |
Late mortality in patients with severe acute pancreatitis
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Citation Context ... but reaches up to 30%–40% in patients with severe disease [13, 14]. Sepsis related multiorgan failure and infected pancreatic necrosis account for about 40–50% of all mortality in acute pancreatitis =-=[13, 15, 16]-=-. Mortality in AP occurs in two peaks [17–21]. Nearly 50% of deaths occur early within the first week due tomassive inflammatory responses leading to multiorgan failure. Septic complications related t... |
9 |
et al: Pathophysiology of acute pancreatitis.
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Citation Context ...rypsin in pancreatic parenchyma acting as the central step in the initiation of autodigestion of pancreatic tissue and subsequent local and systemic inflammation is presently the most accepted theory =-=[17, 18, 30, 31]-=-. Whatever is the initiating event, the disease progression can be viewed as a threephase continuum: local inflammation of the pancreas and a generalized inflammatory response followed by the final st... |
8 |
Classification of the severity of acute pancreatitis: how many categories make sense
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Citation Context ... may either be due to increased incidence of gallstone disease or improvement in diagnostic modalities [8]. The revised Atlanta classification system has classified AP into mild, moderate, and severe =-=[9, 10]-=-. More than 80% of acute pancreatitis attacks are mild and self-limiting and resolve without serious complications. In 20% of cases, however, it can be severe and complicated by major morbidity or mor... |
8 |
Acute pancreatitis.
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Citation Context ...than 80% of acute pancreatitis attacks are mild and self-limiting and resolve without serious complications. In 20% of cases, however, it can be severe and complicated by major morbidity or mortality =-=[3, 11, 12]-=-. Moderate acute pancreatitis is characterized by the presence of transient organ failure or local/systemic complications [10]. Persistent organ failure is the feature of severe acute pancreatitis whi... |
8 |
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Citation Context ...46]. Sensitivity and specificity of amylase as a diagnostic test for AP depend on its threshold value. At a cut-off level of 1000 IU/L, it has a sensitivity of around 55–84% and specificity up to 95% =-=[36, 38, 46, 47]-=-. Journal of Biomarkers 3 Impaired Cell Membrane Trafficking Acinar cell damage (1) Fusion of lysosomal and zymogen grannule Trypsinogen Trypsin (2) Trypsin activates zymogen cascade (3) Secretory ves... |
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Early prediction of severity in acute pancreatitis. Is this possible
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Citation Context ...y Stratification and Its Assessment Acute pancreatitis is self-limiting in 75%–80% of cases and does not require any treatment other than parenteral intravenous fluid, analgesics, and supportive care =-=[4, 22, 23]-=-. The remaining may suffer from severe attacks, with the mortality reaching up to 30%–50% [18]. This subgroup of patients needs to be identified early in the course of the disease and needs to be aggr... |
7 |
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Citation Context ...) or transabdominal ultrasonography. The pancreatic enzymes derived from pancreatic acinar cells [amylase, lipase, and the proenzyme trypsinogen] are the cornerstone in the laboratory diagnosis of AP =-=[36]-=-. Serum lipase is a more sensitive and specific biochemical marker of AP than the more frequently used amylase. Moreover, serum amylase level offers no additional advantage if simultaneously measured ... |
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Citation Context ...le to either gallstone disease or alcohol abuse [3, 4]. The incidence is similar in both sexes, although alcohol abuse is the more common cause in men and gallstones is the more common cause in women =-=[5, 6]-=-. There is an upsurge in the incidence of AP over the last few decades, although the case fatality rate has remained unchanged [7]. This may either be due to increased incidence of gallstone disease o... |
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Citation Context ...ue for assessing the same [65]. 5.2. C-Reactive Protein (CRP). CRP is an acute phase reactant synthesized by the hepatocytes and is usually elevated in Journal of Biomarkers 5 inflammatory conditions =-=[66]-=-. Cytokines like IL-6 are potent inducers of CRP synthesis in liver. It takes nearly 72 hours for the serum level of CRP to peak after the onset of symptoms [56]. It is the most frequently used single... |
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Citation Context ...a predictor of severity in AP [56]. At this cut-off level, CRP has a sensitivity of 80–86% and specificity of 61–84% for diagnosing necrotizing pancreatitis within first 48 hours of onset of symptoms =-=[56, 67]-=-. In their study, Khanna et al. found a 100% sensitivity and 81.4% specificity for detection of pancreatic necrosis [56]. The demerit of CRP as marker is its delayed peak (48–72 hours) and its nonspec... |
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Citation Context ...46]. Sensitivity and specificity of amylase as a diagnostic test for AP depend on its threshold value. At a cut-off level of 1000 IU/L, it has a sensitivity of around 55–84% and specificity up to 95% =-=[36, 38, 46, 47]-=-. Journal of Biomarkers 3 Impaired Cell Membrane Trafficking Acinar cell damage (1) Fusion of lysosomal and zymogen grannule Trypsinogen Trypsin (2) Trypsin activates zymogen cascade (3) Secretory ves... |
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Citation Context ...ion for diagnosis of acute pancreatitis include pancreatic isoamylase, pancreatic elastase, serum trypsin, urinary trypsinogen activated peptide (TAP), Phospholipase A2, and Carboxypeptidase B (CAPB) =-=[39, 40]-=-. Serum trypsin and elastase are of particular interest because of their longer half-life which makes them useful in diagnosis during delayed presentations [41]. These tests, however, have not found m... |
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Citation Context ...e A2, and Carboxypeptidase B (CAPB) [39, 40]. Serum trypsin and elastase are of particular interest because of their longer half-life which makes them useful in diagnosis during delayed presentations =-=[41]-=-. These tests, however, have not found much favor in clinical application because of a variety of reasons including inferior diagnostic accuracy compared to amylase and lipase, cumbersome techniques, ... |
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Citation Context ...e, which is an integral part of severe acute pancreatitis [57]. Among various proinflammatory and antiinflammatory cytokines, IL-6 has the best sensitivity and specificity for early assessment of SAP =-=[58]-=-. With a cutoff value of 50 pg/mL, Jiang et al. have found a sensitivity and specificity of 100% and 89.7%, respectively [59]. With a similar cut-off level, Khanna et al. found a sensitivity of 93.1% ... |
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Citation Context ... IL-6 has the best sensitivity and specificity for early assessment of SAP [58]. With a cutoff value of 50 pg/mL, Jiang et al. have found a sensitivity and specificity of 100% and 89.7%, respectively =-=[59]-=-. With a similar cut-off level, Khanna et al. found a sensitivity of 93.1% and specificity of 96.8% in their study [56]. The major drawback of IL-6 assay is that its serum concentration decreases very... |
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Citation Context ...egative predictive values were 78% and 96%, respectively, and the area under the receiver operator curve was 0.956 [74]. Similar result has been found by Gross et al. and Wilson et al. in their study =-=[75, 76]-=-. More recent studies, however, by a Swiss group and the Japanese have yielded conflicting results [77, 78]. Domı́nguez-Muñoz et al. found quantification of plasma PMN elastase levels as a very accur... |
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Citation Context ...atitis CAPAP level correlated well, with an accuracy of 92%, in predicting development of pancreatic necrosis, whereas the level of its proenzyme did not show any correlation with pancreatic necrosis =-=[87]-=-. Both CAPAP and urinary TAP are excellent prognostic markers, although TAP is a better marker on the day of admission [88]. 5.6.4. Trysinogen-2. In acute pancreatitis the level of trysinogen-2 rises ... |
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Citation Context ...mmon cause in men and gallstones is the more common cause in women [5, 6]. There is an upsurge in the incidence of AP over the last few decades, although the case fatality rate has remained unchanged =-=[7]-=-. This may either be due to increased incidence of gallstone disease or improvement in diagnostic modalities [8]. The revised Atlanta classification system has classified AP into mild, moderate, and s... |
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Citation Context ...than 80% of acute pancreatitis attacks are mild and self-limiting and resolve without serious complications. In 20% of cases, however, it can be severe and complicated by major morbidity or mortality =-=[3, 11, 12]-=-. Moderate acute pancreatitis is characterized by the presence of transient organ failure or local/systemic complications [10]. Persistent organ failure is the feature of severe acute pancreatitis whi... |
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Citation Context ...creas and a generalized inflammatory response followed by the final stage of multiorgan dysfunction [17, 18, 30, 31]. Figure 1 illustrates the schematic overview of pathogenesis of acute pancreatitis =-=[32, 33]-=-. In the early phase, inflammation is usually localized to the pancreaswhich clinicallymanifests asmild acute pancreatitis. This usually resolves within a week without any local or systemic complicati... |
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Citation Context ...t correlate with resolution of clinical symptoms [43]. Furthermore, the magnitude of the hyperamylasemia does not show significant statistical correlation with disease severity and ultimate prognosis =-=[44]-=-. In 19–32% of cases amylase activity may be normal at the time of hospital admission due to delayed presentation or exocrine pancreatic insufficiency (chronic alcoholism) [36, 43]. Raised serum amyla... |
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Procalcitonin strip test in the early detection of severe acute pancreatitis
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Citation Context ...erity [69]. For faster result, PCT level can be measured by a semiquantitative strip test with a cut-off level of 0.5 ng/mL. Formore accuratemeasurements however fully automated assay should be opted =-=[70]-=-. An increased PCT level has been found to be an early predictor of severity, pancreatic necrosis, and organ failure in patients with AP [70–72]. In a recent meta-analysis, a subgroup of 8 studies usi... |
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Citation Context ...s 0.956 [74]. Similar result has been found by Gross et al. and Wilson et al. in their study [75, 76]. More recent studies, however, by a Swiss group and the Japanese have yielded conflicting results =-=[77, 78]-=-. Domı́nguez-Muñoz et al. found quantification of plasma PMN elastase levels as a very accurate method for the early prognostic evaluation of AP and found its applicability in the clinical setting [7... |
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Citation Context ...hemical markers in the diagnosis and severity evaluation in acute pancreatitis. 1. Introduction Acute pancreatitis (AP) is a potentially life threatening disease with varying severity of presentation =-=[1, 2]-=-. Nearly 60%–80% of all cases of AP in developed countries are attributable to either gallstone disease or alcohol abuse [3, 4]. The incidence is similar in both sexes, although alcohol abuse is the m... |
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Citation Context ...re is the feature of severe acute pancreatitis which is associated with a high rate of mortality. The overall mortality of AP is about 10–15% but reaches up to 30%–40% in patients with severe disease =-=[13, 14]-=-. Sepsis related multiorgan failure and infected pancreatic necrosis account for about 40–50% of all mortality in acute pancreatitis [13, 15, 16]. Mortality in AP occurs in two peaks [17–21]. Nearly 5... |
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Citation Context ...re is the feature of severe acute pancreatitis which is associated with a high rate of mortality. The overall mortality of AP is about 10–15% but reaches up to 30%–40% in patients with severe disease =-=[13, 14]-=-. Sepsis related multiorgan failure and infected pancreatic necrosis account for about 40–50% of all mortality in acute pancreatitis [13, 15, 16]. Mortality in AP occurs in two peaks [17–21]. Nearly 5... |
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Citation Context ...Interleukins. Interleukin-6 (IL-6) is produced by a wide range of cells like monocytes, macrophage, endothelium, and fibroblast in response to potent proinflammatory stimulus like TNF-alpha and IL-1... |
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Citation Context ...ion for diagnosis of acute pancreatitis include pancreatic isoamylase, pancreatic elastase, serum trypsin, urinary trypsinogen activated peptide (TAP), Phospholipase A2, and Carboxypeptidase B (CAPB) =-=[39, 40]-=-. Serum trypsin and elastase are of particular interest because of their longer half-life which makes them useful in diagnosis during delayed presentations [41]. These tests, however, have not found m... |
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Citation Context ... to potent proinflammatory stimulus like TNF-alpha and IL-1... |
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et al., “Comparison of Ranson
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Citation Context ...of IL-6 is significantly elevated in SAP on the day of admission and tends to peak at 72 hrs after the clinical onset of disease, which makes IL-6 an excellent marker of early severity stratification =-=[56]-=-. In terms of predicting complications, IL-6 was found to be excellent in predicting remote organ failure, which is an integral part of severe acute pancreatitis [57]. Among various proinflammatory an... |
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interleukin-8 and interleukin-10 in estimating the severity of acute pancreatitis: an updated meta-analysis. Hepatogastroenterology. 61: 215–20
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Citation Context ...g et al., IL-6, IL-8, and IL-10 have shown promising results in predicting severe acute pancreatitis. They, however, found a lack of consensus regarding the ideal cut-off value for assessing the same =-=[65]-=-. 5.2. C-Reactive Protein (CRP). CRP is an acute phase reactant synthesized by the hepatocytes and is usually elevated in Journal of Biomarkers 5 inflammatory conditions [66]. Cytokines like IL-6 are ... |
2 |
Trigo et al., “Comparative study of the activation peptide of carboxypeptidase B and of trypsinogen as early predictors of the severity of acute pancreatitis
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Citation Context ...level of its proenzyme did not show any correlation with pancreatic necrosis [87]. Both CAPAP and urinary TAP are excellent prognostic markers, although TAP is a better marker on the day of admission =-=[88]-=-. 5.6.4. Trysinogen-2. In acute pancreatitis the level of trysinogen-2 rises considerably more than that of trysinogen-1 [14]. High level of trypsinogen-2 can be found in both serum and urine. High se... |
2 | Puolakkainen et al., “Increased serum trypsinogen 2 and trypsin 2-alpha-1-antitrypsin complex values identify endoscopic retrograde cholangiopancreatography induced pancreatitis with high accuracy,”Gut - Kemppainen, Hedström, et al. - 1997 |
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Kenkimäki et al., “Urinary trypsinogen-2 test strip for acute pancreatitis
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Citation Context ...lowing ERCP induced pancreatitis [89–91]. High urinary trpsinogen-2 is used as a screening test for diagnosis of AP. A rapid dipstick method has been devised for rapid diagnosis of acute pancreatitis =-=[92]-=-. This test is particularly useful in rapid diagnosis of ERCP induced pancreatitis. Overall trysinogen-2 appears to be more useful as a diagnostic marker than as a predictor of severity [93]. 6 Journa... |
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et al., “Urinary trypsinogen activation peptide as a marker of severe acute pancreatitis
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Citation Context ...creatitis [92]. This test is particularly useful in rapid diagnosis of ERCP induced pancreatitis. Overall trysinogen-2 appears to be more useful as a diagnostic marker than as a predictor of severity =-=[93]-=-. 6 Journal of Biomarkers 6. Emerging Potential Biomarkers for Prediction of Severity in AP 6.1. Tissue Factor. Tissue factor is a transmembrane glycoprotein involved in the initiation of coagulation ... |
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Citation Context ...tentially life threatening disease with varying severity of presentation [1, 2]. Nearly 60%–80% of all cases of AP in developed countries are attributable to either gallstone disease or alcohol abuse =-=[3, 4]-=-. The incidence is similar in both sexes, although alcohol abuse is the more common cause in men and gallstones is the more common cause in women [5, 6]. There is an upsurge in the incidence of AP ove... |
1 |
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Citation Context ...le to either gallstone disease or alcohol abuse [3, 4]. The incidence is similar in both sexes, although alcohol abuse is the more common cause in men and gallstones is the more common cause in women =-=[5, 6]-=-. There is an upsurge in the incidence of AP over the last few decades, although the case fatality rate has remained unchanged [7]. This may either be due to increased incidence of gallstone disease o... |
1 |
et al., “Low mortality and high morbidity in severe acute pancreatitis without organ failure: A case for revising the Atlanta classification to include ‘moderately severe acute pancreatitis
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Citation Context ... may either be due to increased incidence of gallstone disease or improvement in diagnostic modalities [8]. The revised Atlanta classification system has classified AP into mild, moderate, and severe =-=[9, 10]-=-. More than 80% of acute pancreatitis attacks are mild and self-limiting and resolve without serious complications. In 20% of cases, however, it can be severe and complicated by major morbidity or mor... |
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Citation Context ..., 13 pages http://dx.doi.org/10.1155/2015/519534 2 Journal of Biomarkers 2. Pathophysiology of Acute Pancreatitis Despite intense research over centuries, the exact pathogenesis of AP remains elusive =-=[3, 26]-=-. Although many theories have been proposed, none of them appear to be complete [3, 27]. Some of the propositions include abnormal biliopancreatic duct common pathway theory, pancreatic autodigestion ... |
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Citation Context ...logy of Acute Pancreatitis Despite intense research over centuries, the exact pathogenesis of AP remains elusive [3, 26]. Although many theories have been proposed, none of them appear to be complete =-=[3, 27]-=-. Some of the propositions include abnormal biliopancreatic duct common pathway theory, pancreatic autodigestion theory, gallstone migration theory, enzyme activation theory, kinin and complement acti... |
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Citation Context ...rse and relative inaccessibility of pancreatic tissue [3]. To overcome this problem, investigators have now taken to animal models to study the molecular aspects of pathogenesis of acute pancreatitis =-=[3, 28, 29]-=-. Further complicating the issue are the paradoxical results about the pathogenesis, obtained from different animals exposed to similar aetiology [5]. The premature activation of trypsin in pancreatic... |
1 |
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Citation Context ...rse and relative inaccessibility of pancreatic tissue [3]. To overcome this problem, investigators have now taken to animal models to study the molecular aspects of pathogenesis of acute pancreatitis =-=[3, 28, 29]-=-. Further complicating the issue are the paradoxical results about the pathogenesis, obtained from different animals exposed to similar aetiology [5]. The premature activation of trypsin in pancreatic... |
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Citation Context ...creatitis is usually based on a combination of clinical findings, laboratory investigations, and imaging techniques. There is no gold standard test available to diagnose acute pancreatitis at present =-=[34, 35]-=-. According to revised Atlanta classification, diagnosis of acute pancreatitis requires two of the following three criteria [1, 22]: (1) Abdominal pain characteristic of AP (acute onset of a persisten... |
1 |
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Citation Context ...creatitis is usually based on a combination of clinical findings, laboratory investigations, and imaging techniques. There is no gold standard test available to diagnose acute pancreatitis at present =-=[34, 35]-=-. According to revised Atlanta classification, diagnosis of acute pancreatitis requires two of the following three criteria [1, 22]: (1) Abdominal pain characteristic of AP (acute onset of a persisten... |
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Acute pancreatitis with normal serum lipase: a case series
- Baddoura
- 2010
(Show Context)
Citation Context ...creatitis, the blood level of amylase rapidly increases within six hours of onset of disease, exhibits a half-life of 10–12 hours, remains elevated for 3–5 days, and finally is excreted by the kidney =-=[33, 36, 42]-=-. After reaching a peak level, subsequent return of serum amylase to its normal level does not correlate with resolution of clinical symptoms [43]. Furthermore, the magnitude of the hyperamylasemia do... |
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et al., “Acute pancreatitis and normoamylasemia. Not an uncommon combination,”Annals
- Clavien, Robert, et al.
- 1989
(Show Context)
Citation Context ...5 days, and finally is excreted by the kidney [33, 36, 42]. After reaching a peak level, subsequent return of serum amylase to its normal level does not correlate with resolution of clinical symptoms =-=[43]-=-. Furthermore, the magnitude of the hyperamylasemia does not show significant statistical correlation with disease severity and ultimate prognosis [44]. In 19–32% of cases amylase activity may be norm... |
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et al., “Prevalence of normal serum amylase levels in patients with acute alcoholic pancreatitis
- Spechler, Dalton, et al.
- 1983
(Show Context)
Citation Context ...renal clearance. Macroamylasemia is a condition in which amylase remains bound to immunoglobulins or polysaccharides to form large molecular weight complexes leading to raised levels of serum amylase =-=[36, 45, 46]-=-. Hypertriglyceridemia competitively interferes with amylase assay, so a false low level of serum amylase can be found in patients having hypertriglyceridemia [36, 46]. Sensitivity and specificity of ... |
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A critical evaluation of laboratory tests in acute pancreatitis
- Yadav, Agarwal, et al.
- 2002
(Show Context)
Citation Context ...renal clearance. Macroamylasemia is a condition in which amylase remains bound to immunoglobulins or polysaccharides to form large molecular weight complexes leading to raised levels of serum amylase =-=[36, 45, 46]-=-. Hypertriglyceridemia competitively interferes with amylase assay, so a false low level of serum amylase can be found in patients having hypertriglyceridemia [36, 46]. Sensitivity and specificity of ... |
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Love Jr., “Assays of serum lipase: analytical and clinical considerations,”Clinical Chemistry
- Lott, Patel, et al.
- 1986
(Show Context)
Citation Context ...ailure and infection of pancreatic necrosis and sepsis with late complications of acute pancreatitis [32, 33]. 3.2. Lipase. Lipase assay has a sensitivity and specificity of 80% and 60%, respectively =-=[35, 48]-=-.The serum concentration of lipase increases within 3–6 hours of onset of disease and peaks within 24 hours [32]. The increased serum level stays for around 7–14 days before it comes down to the norma... |
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Lipase in serum: the elusive enzyme: an overview,”Clinical Chemistry
- Tietz, Shuey
- 1993
(Show Context)
Citation Context ...ts with delayed presentation [32, 36]. Pancreatic lipase is four times more active than amylase and it is less affected by exocrine pancreatic deficiency occurring in patients of chronic pancreatitis =-=[36, 49]-=-. Hypertriglyceridemia does not influence the serum lipase assay as happens in the case of serum amylase. Patients taking frusemide can show increased lipase activity [36]. Increased serum level of li... |
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Puolakkainen et al., “Comparison of urine trypsinogen-2 test stripwith serum lipase in the diagnosis of acute pancreatitis,”Hepato-Gastroenterology
- Kylänpää-Bäck, Kemppainen, et al.
- 2002
(Show Context)
Citation Context ...me; MARS: mixed antagonist response syndrome; SIRS: systemic inflammatory response syndrome; Mild AP: mild acute pancreatitis [1]. however, serum lipase level’s sensitivity is limited between 55–100% =-=[36, 51]-=-. Like that of amylase, most studies suggest a poor correlation between lipase activity and disease severity [44]. 3.3. Trypsinogen. Trypsinogen is the zymogen of the pancreatic enzyme trypsin which i... |
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Different patterns in immunoreactive anionic and cationic trypsinogen in urine and serum in human acute pancreatitis
- Borgström
- 1999
(Show Context)
Citation Context ...f the use of trypsinogen in the diagnosis and severity assessment of AP [32]. Both serum and urine concentrations risewithin fewhours of onset of disease anddecline to normal level within 3 to 5 days =-=[32, 36, 52]-=-. A dipstick method using urinary trysinogen-2 has been devised for rapid detection of AP [32, 53]. Because of its low sensitivity and less availability, this test is less frequently used in routine c... |
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Onal, “Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: a prospective study
- Kamer, Unalp, et al.
- 2007
(Show Context)
Citation Context ...centrations risewithin fewhours of onset of disease anddecline to normal level within 3 to 5 days [32, 36, 52]. A dipstick method using urinary trysinogen-2 has been devised for rapid detection of AP =-=[32, 53]-=-. Because of its low sensitivity and less availability, this test is less frequently used in routine clinical practice [32]. The greatest demerit of trypsinogen as a diagnostic test is its rapid clear... |
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et al., “Interleukin-8 and neutrophil activation in acute pancreatitis
- Gross, Andreesen, et al.
- 1992
(Show Context)
Citation Context ...lexity of assay [36]. IL-8 is the best characterized member of the chemokine family studied in acute pancreatitis. It is a powerful secondary chemoattractant of neutrophil in the inflammatory process =-=[60]-=-. Many studies have shown promising results in early prediction of SAP [60]. One study has shown its role in monitoring life threatening complications in patients of necrotizing pancreatitis with mult... |
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The role of interleukin-8 in the severity assessment of septic complications in necrotizing pancreatitis
- Rau, Steinbach, et al.
- 1997
(Show Context)
Citation Context ...have shown promising results in early prediction of SAP [60]. One study has shown its role in monitoring life threatening complications in patients of necrotizing pancreatitis with multiorgan failure =-=[61]-=-. IL-12, IL-15, and IL-17 are proinflammatory cytokines which have been studied recently as potential biomarkers. Similar results have been seen in various studies as single biochemical markers on the... |
1 | Stanković et al., “Interleukin-12 as a predictor of outcome in patients with severe acute pancreatitis - Gregorić, Doklestić, et al. - 2014 |
1 | et al., “Serum interleukin-15 level is a useful predictor of the complications and mortality in severe acute pancreatitis - Ueda, Takeyama, et al. - 2007 |
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et al., “Comparison of serum procalcitonin with Ranson, APACHE-II, Glasgow and Balthazar CT severity index scores in predicting severity of acute pancreatitis,”The Korean
- Woo, Noh, et al.
- 2011
(Show Context)
Citation Context ...e [68]. Because severe acute pancreatitis is associated with sepsis, infected pancreatic necrosis, and multiorgan failure, procalcitonin can be used as a useful marker in early prediction of severity =-=[69]-=-. For faster result, PCT level can be measured by a semiquantitative strip test with a cut-off level of 0.5 ng/mL. Formore accuratemeasurements however fully automated assay should be opted [70]. An i... |
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Lariño et al., “Accuracy of plasma levels of polymorphonuclear elastase as early prognostic marker of acute pancreatitis in routine clinical conditions
- Domı́nguez-Muñoz, Villanueva, et al.
- 2006
(Show Context)
Citation Context ...N Elastase). PMN Elastase is the protease released by activated neutrophil as a first line defense following tissue injury [36]. Granulocyte infiltration and activation occur in the early phase of AP =-=[74]-=-. So PMNElastase has been proved as an earlymarker of severe acute pancreatitis within 48 hours of onset of symptoms. With a cut-off level of 110 ... |
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et al., “Granulocyte elastase in assessment of acute pancreatitis
- Gross, Leser
- 1990
(Show Context)
Citation Context ...egative predictive values were 78% and 96%, respectively, and the area under the receiver operator curve was 0.956 [74]. Similar result has been found by Gross et al. and Wilson et al. in their study =-=[75, 76]-=-. More recent studies, however, by a Swiss group and the Japanese have yielded conflicting results [77, 78]. Domı́nguez-Muñoz et al. found quantification of plasma PMN elastase levels as a very accur... |
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B.Mermillod et al., “Early prediction of acute pancreatitis: prospective study comparing computed tomography scans
- Robert, Frossard
- 2002
(Show Context)
Citation Context ...s 0.956 [74]. Similar result has been found by Gross et al. and Wilson et al. in their study [75, 76]. More recent studies, however, by a Swiss group and the Japanese have yielded conflicting results =-=[77, 78]-=-. Domı́nguez-Muñoz et al. found quantification of plasma PMN elastase levels as a very accurate method for the early prognostic evaluation of AP and found its applicability in the clinical setting [7... |
1 | Garćıa et al., “Monitoring of serum proteinase-antiproteinase balance and systemic inflammatory response in prognostic evaluation of acute pancreatitis. Results of a prospective multicenter study,” Digestive Diseases and Sciences - Domı́nguez-Muñoz, Carballo, et al. - 1993 |
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et al., “Prediction of the severity of acute pancreatitis on admission by urinary trypsinogen activation peptide: a meta-analysis,”World
- Huang, Altaf, et al.
- 2013
(Show Context)
Citation Context ...al fluid. TAP activity increases early in the course of the disease and attains maximal value within 24–48 hours. Huang et al. did a meta-analysis on the role of urinary TAP in prediction of severity =-=[85]-=-. They found a sensitivity of 71% and specificity of 75% with an area under curve of 0.83 with a cut-off value of 35 nmol/L. This was comparable to the sensitivity and specificity of CRP and was bette... |
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The activation peptide of carboxypeptidase B in serum and urine in acute pancreatitis
- Borgström
- 1998
(Show Context)
Citation Context ... potential severity stratification marker for acute pancreatitis [67, 85]. 5.6.3. Carboxypeptidase B Activation Peptide (CAPAP). It is the largest activation peptide amongst the pancreatic proenzymes =-=[86]-=-. This peptide is very stable in urine and serum. In a study of 85 patients with acute pancreatitis CAPAP level correlated well, with an accuracy of 92%, in predicting development of pancreatic necros... |
1 | et al., “Predicting the severity of acute pancreatitis by rapid measurement - Lempinen, Kylänpää-bäck, et al. - 2001 |
1 | Tissue factor in predicted severe acute pancreatitis,”World
- Andersson, Axelsson, et al.
- 2010
(Show Context)
Citation Context ...und that TF as a predictor of severity is not as good as IL-6 or CRP. High serum level early in the course may suggest a role in the pathogenesis of AP and give a window for therapeutic interventions =-=[94]-=-. 6.2. Prealbumin to Fibrinogen Ratio. Prealbumin and Fibrinogen are acute phase reactants. Prealbumin is mostly used for assessment of nutritional status, whereas fibrinogen is usedmostly for assessm... |
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Ding et al., “The predictive value of the prealbumin-to-fibrinogen ratio in patients with acute pancreatitis
- Yue, Liu, et al.
- 2015
(Show Context)
Citation Context ... et al., it has superior sensitivity, specificity, positive predictive value (PPV), and NPV of 76.5%, 94.1%, 89.6%, and 85.6%, respectively, at a cut-off level of 31.70mg/g than other scoring systems =-=[95]-=-. 6.3. Cytokeratin 18. This is an epithelial cell structural protein, associatedwith apoptotic cell death. Recent animal studies have shown that wide apoptotic cell death is associated with a milder f... |
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The relation between serum cytokeratin 18 and acute pancreatitis: can it be a serological predictive marker?” Turkish
- Koruk, Özdemir, et al.
- 2012
(Show Context)
Citation Context ...el of cytokeratin 18 in patients with mild acute pancreatitis (271.2 ± 45.5 versus 152.6± 38.2 IU/L;... |
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Aslan et al., “Hepcidin as a predictor of disease severity in acute pancreatitis: a single center prospective study
- Arabul, Celik, et al.
- 2013
(Show Context)
Citation Context ...le centre prospective study to assess its role in prediction of severity in AP. They found hepcidin is a better predictive marker for SAP compared to CRP with an AUC of 0.79 versus 0.69, respectively =-=[97]-=-. 6.5. Copeptin. Copeptin is a long amino acid peptide derived from a preprohormone consisting of neurophysin II, vasopressin, and copeptin. Its level rises during stress in critically ill patients. I... |
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Isbilen et al., “Copeptin is a predictive biomarker of severity in acute pancreatitis
- Isman, Zulfikaroglu, et al.
- 2013
(Show Context)
Citation Context ...admission in patients with SAP. Isman et al. also found that copeptin can be used as a novel prognostic marker for prediction of local complication, organ failure, and mortality in acute pancreatitis =-=[98]-=-. 6.6. Soluble E-Selectin (sES) and Soluble Thrombomodulin (sTM). Soluble ES is an endothelial activation marker, whereas soluble TM is an endothelial injury marker. During acute pancreatitis activate... |
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et al., “Significance of endothelial molecular markers in the evaluation of the severity of acute pancreatitis
- Ida, Fujimura, et al.
- 2009
(Show Context)
Citation Context ...ing acute pancreatitis activated neutrophils release elastase which damages the endothelium. Ida et al. studied these two markers to find their significance in assessment of severe acute pancreatitis =-=[99]-=-. They concluded that those high levels of soluble ES can be found in all stages of the disease; therefore it can be used tomonitor the disease severity. SolubleTMcanbe used as a predictive parker of ... |
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Is there a role for serum endothelin in predicting the severity of acute pancreatitis
- Bennett, Cooper, et al.
- 2006
(Show Context)
Citation Context ...lin have been found to be associated with acute pancreatitis with a strong correlation with the disease severity. High level of endothelin 1 can be used as a marker to monitor the disease progression =-=[100]-=-. 6.8. Melatonin Concentration. Melatonin plays a protective role in the early phase of acute pancreatitis in the form of an antioxidant or scavengers of free radicals, inhibition of nuclear factor ka... |