Serum TNF-Alpha Levels in Acute and Chronic Pancreatitis

Analysis of risk factors related to acute exacerbation in patients with chronic pancreatitis: a retrospective study of 313 cases from a single center in China

BACKGROUND

Acute on chronic pancreatitis(ACP) is a common cause of treatment in patients with chronic pancreatitis(CP). However, as far as we know, research on ACP has been few, and the quality may vary. This study intended to explore the risk factors related to acute exacerbation in patients with chronic pancreatitis.

METHODS

313 patients with CP were analyzed based on clinical data from 2014 to 2023 and categorized into ACP and non-ACP groups. Their data, assessed across eleven parameters, were used to study risk variables associated with acute exacerbation in patients with chronic pancreatitis.

RESULTS

Of the 313 eligible patients, 163(52.1%) were ACP. Age > 50 years old (P = 0.049, OR = 0.614, 95%CI: 0.378-0.998), recurrent acute pancreatitis(RAP) history (P = 0.000, OR = 3.284, 95%CI: 1.972-5.467) and steatorrhea (P = 0.013, OR = 0.189, 95%CI: 0.051-0.704) were related factors for ACP.

CONCLUSION

The history of RAP was an independent risk factor for ACP. Age and steatosis were protective of the prevalence of ACP.

Adipokines and their role in acute pancreatitis

Acute pancreatitis (AP) is characterized by an inflammatory response that leads to edema and haemorrhaging of pancreatic tissue. In severe cases, it can even result in the necrosis of pancreatic tissue following activation within the pancreas. Adipokines are biologically active molecules released by adipose tissue that have a wide-ranging impact on health and disease. Adipokines are cytokines produced not only in white adipose tissue but also in the fat surrounding the pancreas, and they play a role in the body's inflammatory response. The presence of increased adipose tissue, often associated with obesity, has been linked to a heightened systemic inflammatory response in cases of AP. According to the literature, there are many adipokines. This article summarizes the role of adipokines in AP. Adipokines could be promising biomarkers for both diagnostic and new therapeutic treatment strategies in AP. However, a deeper knowledge of the signaling pathways of adipokines and their potential therapeutic role in AP is necessary.

Acute-on-Chronic Pancreatitis: Analysis of Clinical Profile and Outcome

OBJECTIVE

Overall, a handful of studies are available on the outcomes of acute-on-chronic pancreatitis (ACP). We aimed to provide a more complete and updated picture of ACP.

METHODS

We evaluated consecutive patients of acute exacerbation of chronic pancreatitis (CP) in a tertiary care center located in north India and studied their epidemiological profiles, etiological factors as well as outcomes.

RESULTS

Forty-five patients of ACP with a mean age of 37±13 years were evaluated. The majority of the patients were male (75%) and alcohol was the most common detectable etiology while no etiology could be identified in 35% of patients after extensive laboratory investigations and imaging. Moderately severe pancreatitis was noted in 73% of patients and 49% of patients had necrotizing pancreatitis out of which the majority (33%) had both pancreatic as well as extra-pancreatic necrosis (EPN). Five patients (11%) were subjected to percutaneous catheter drainage. Persistent organ failure was noted in 9% of patients and two (4.5%) patients had died from organ failure.

CONCLUSION

To conclude, this study has demonstrated that ACP has a milder disease course and low morbidity and mortality. Early elimination of the etiological factor is essential for optimal outcome.

Effects of Ganoderma lucidum polysaccharides on chronic pancreatitis and intestinal microbiota in mice

This study manifested the effects of polysaccharides from Ganoderma lucidum strain S₃ (GLP S₃) on chronic pancreatitis (CP) therapy and intestinal microbiota modulation in mice induced by diethyldithiocarbamate (DDC). The GLPS₃ was prepared from cultured mycelium and markedly alleviated the pancreatitis in mice through decreasing lipase, AMS, IFN-γ and TNF-α level as well as increasing SOD and total antioxidant activity. Furthermore, high throughput sequencing analysis revealed that GLPS₃ altered the composition and diversity of intestinal microbiota, especially, decreased the relative abundance of phylum Bacteroidetes and increased that of phylum Firmictutes. At the genus level, supplementation of GLPS₃ increased the relative abundance of the beneficial bacteria such as Lactobacillales, Roseburia and Lachnospiraceae. These results disclosed the potential therapy mechanism of GLPS₃ on chronic pancreatitis might be intestinal microbiota dependent.

A single-nucleotide polymorphism in tumor necrosis factor-α (-308 G/A) as a biomarker in chronic pancreatitis

OBJECTIVE

Chronic pancreatitis is a gradual, long-term inflammation of the pancreas that results in alteration of its normal structure and function. The study aims to investigate the role of -308 (G/A) polymorphism of TNF-α gene in chronic pancreatitis.

MATERIAL AND METHODS

A total of 200 subjects were included in this case-control study. A total of 100 in patients admitted in the Gastroenterology Unit of Gandhi Hospital and Osmania General Hospital, Hyderabad were included in the present study. An equal number of healthy control subjects were randomly selected for the study. The genotyping of TNF-α gene was carried out by tetra-primer ARMS PCR followed by gel electrophoresis. The TNF-α levels were assayed by enzyme-linked immunosorbent assay.

RESULTS

A significant variation with respect to the genotypic and allelic distribution in the disease group when compared to control subjects [OR=2.001 (1.33-3.005), p<0.0001**] was observed. Subjects homozygous for the A allele had higher TNF-α levels compared to G allele.

CONCLUSION

The present study revealed a significant association of the TNF-α gene promoter polymorphism with chronic pancreatitis. Thus, TNF-α genotype can be considered as one of the biological markers in the etiology of chronic pancreatitis.

Matrix metalloproteinase-9, transforming growth factor-β1, and tumor necrosis factor-α plasma levels in chronic pancreatitis

OBJECTIVE

The aim of the study was to investigate the plasma levels of matrix metalloproteinase-9 (MMP-9), transforming growth factor-β 1 (TGF-β1), and tumor necrosis factor-α (TNF-α) in chronic pancreatitis (CP).

METHODS

Blood samples were obtained from 71 patients with CP and 100 control subjects, and plasma levels of MMP-9, TGF-β1, and TNF-α were determined by enzyme-linked immunosorbent assay.

RESULTS

The plasma levels of MMP-9 (18.3 ± 3.0 ng/mL, p < 0.0001), TGF-β1 (215.4 ± 178.1 ng/mL, p = 0.0301), and TNF-α (111.2 ± 69.3 ng/mL, p < 0.001) were significantly elevated in CP compared to the control group.

CONCLUSION

The role of elevated plasma MMP-9, TGF-β1, and TNF-α in CP requires further evaluation.