Increased risk of acute pancreatitis following pneumococcal pneumonia: a nationwide cohort study

Rheumatoid arthritis and risk of pancreatitis: a nationwide cohort study

We aimed to assess whether patients with rheumatoid arthritis (RA) have a higher risk of developing acute and chronic pancreatitis compared to individuals without RA. We identified 54,910 individuals with RA between 2010 and 2017. After exclusion, they were matched in a 1:3 ratio based on age and gender to control population without RA. Cox regression analyses were performed to estimate hazard ratio. During a median follow-up of 5.5 years, 0.18% of the patients with RA and 0.14% of the matched control developed acute pancreatitis. The risk acute pancreatitis was higher in the RA cohort compared to matched control (adjusted hazard ratio [aHR] 1.33; 95% confidence interval [CI] 1.02-1.74). In the case of chronic pancreatitis, 0.11% of patients with RA and 0.09% of the matched control developed chronic pancreatitis. Patients with RA appear to have a marginally elevated risk of chronic pancreatitis compared to matched controls (aHR 1.25, 95% CI 0.90-1.74), though this increase did not achieve statistical significance. The risk of acute pancreatitis is slightly higher in individuals with RA than in matched controls. The risk of chronic pancreatitis did not show statistical significance, but it tended to increase marginally in patients with RA.

Elevated Level of miR-551b-5p is Associated With Inflammation and Disease Progression in Patients With Severe Acute Pancreatitis

Circulating microRNAs have the potential to be noninvasive biomarkers for assessing disease progression. MicroRNA-551b-5p (miR-551b-5p) was previously reported to be differentially expressed in pancreatic patients. The serum miR-551b-5p level was measured in patients with mild acute pancreatitis (MAP), severe acute pancreatitis (SAP), and healthy controls using quantitative real-time polymerase chain reaction (RT-PCR) analysis to evaluate its impact on inflammatory response. Acute Physiology and Chronic Health Evaluation II (APACHE II), Multiple Organ Dysfunction Score (MODS), Sequential Organ Assessment Score (SOFA), and Ranson's scores were recorded. Inflammatory cytokines, IL-6, IL-17, IL-1β, and Tumor Necrosis Factor-α (TNF-α), were detected in serum samples obtained from MAP and SAP patients on admission day 1, day 3, and day 5 using Enzyme Linked Immunosorbent Assay (ELISA). Inflammatory cytokines were analyzed in peripheral blood mononuclear cells (PBMCs), which were transfected with miR-551b-5p-negative controls and inhibitors. The serum miR-551b-5p level was significantly higher in MAP and SAP patients compared to controls (P < 0.001). An elevated miR-551b-5p level is positively associated with APACHE II, MODS, SOFA, and Ranson's scores (P < 0.001). Serum cytokines levels were significantly elevated in MAP and SAP patients compared to controls (P < 0.05). In addition, the level of these inflammatory cytokines was increased in PBMCs of SAP patients in comparison with those of healthy controls (P < 0.05), and this rise was significantly reduced with the addition of an miR-551b-5p inhibitor. In conclusion, serum miR-551b-5p is elevated in patients with MAP and SAP and is involved in the regulation of inflammatory response. It may be a useful biomarker for assessing the severity of SAP.