Abstract
Calprotectin (Cal) concentration is elevated in acute inflammatory reactions and its increase in the plasma suggests a diagnostic potential for Cal assay. This study aimed (a) to evaluate the Cal plasma levels in patients suffering from acute pancreatitis (AP) and (b) to assess whether early assay of Cal plasma levels can be helpful in assessment of the severity of AP. Forty-six consecutive patients, median age 45 years, suffering from a first attack of AP were recruited at two medical centers. Data collected on admission included age, sex, delay between pain onset and admission, and Glasgow score. A severe outcome was defined according to the Atlanta criteria. AP was defined as edematous or necrotic according to the CT findings. Plasma Cal and serum C reactive protein (CRP) were assayed in all patients within the first 24 hr after hospitalization. Sixty subjects suffering from blood hypertension were recruited as controls. Plasma Cal was measured by a commercial ELISA system. In all AP patients and in none of the controls, plasma Cal concentration was higher than the normal limit. Cal values in AP patients were significantly higher than in controls (P < 0.0001). There was not a statistically significant difference in Cal values between patients with severe and patients with mild AP. Plasma Cal values did not differ in necrotizing and edematous AP. During the follow-up plasma Cal was reassayed in six of the patients with abdominal fluid collection and the values were higher in the two patients with infected necrosis. We conclude that plasma Cal is elevated in patients with AP but it is not a useful marker for early prediction of pancreatitis severity. Further studies could evaluate its usefulness in pancreatic infected necrosis.
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References
Fagerhol MK (1996) Nomenclature for proteins: Is calprotectin a proper name for the elusive myelomonocytic protein? J Clin Pathol Mol Pathol 49:M74–M79
Johne B, Fagerhol MK, Lyberg T, et al. (1997) Functional and clinical aspects of the myelomonocyte protein calprotectin. Mol Pathol 50:113–123
Brun JG, Ulvestad E, Fagerhol MK, Jonsson R (1994) Effects of human calprotectin on in vitro immunoglobulin synthesis. Scand J Immunol 40:675–680
Steinbakk M, Naess-Andresen CF, Lingaas E, Dale I, Brandtzeg P, Fagerhol MK (1990) Antimicrobial actions of calcium binding leucocyte L1 protein, calprotectin. Lancet 336:763–765
Berntzen HB, Olmez U, Fagerhol MK, Munthe E (1991) The L1 protein as a new indicator of inflammatory activity in patients with juvenile rheumatoid arthritis. J Rheumatol 18:1338–1339
Kronborg O, Ugstad M, Fuglerud P, et al. (2000) Fecal calprotectin levels in a risk population for colorectal neoplasia. Gut 46:795–800
Tibble J, Teahon K, Thjodleifsson B, et al. (2000) A simple method for assessing intestinal inflammation in Crohn’s disease. Gut 47:506–513
Carroccio A, Iacono G, Cottone M, et al. (2003) Diagnostic accuracy of fecal calprotectin assay in distinguishing organic causes of chronic diarrhea from irritable bowel syndrome: a prospective study in adults and children. Clin Chem 49(6):861–867
Imrie CW, Benjamin IS, Ferguson JC, et al. (1978) A single-center double-blind trial of Trasylol therapy in primary acute pancreatitis. Br J Surg 65:337–341
Bradley EL (1993) A clinically based classification system for acute pancreatitis. Arch Surg 128:586–590
Haga HJ, Brun JG, Berntzen HB, Cervera R, Khamashta M, Huges GRV (1993) Calprotectin in patients with systemic lupus erythematosous: relation to clinical and laboratory parameters of disease activity. Lupus 2:47–50
Golden BE, Clohessy PA, Russell G, Fagerhol MK (1996) Calprotectin as a marker of inflammation in cystic fibrosis. Arch Dis Child 74:136–139
Stockley RA, Dale I, Hill SL, Fagerhol MK (1984) Relationship of neutrophil cytoplasmic protein (L1) to acute and chronic lung disease. Scand J Clin Lab Invest 44:629–634
Fanjul M, Renaud W, Merten M, Guycrotte O, Hollande E, Figarella C (1995) Presence of MRP8 and MRP14 in pancreatic cells lines: differential expression and localization in CFPAC-1 cells. Am J Physiol Cell Physiol 37:C1241–C1251
Appelros S, Petersson U, Toh S, Johnson C, Borgstrom A (2001) Activation peptide of carboxypeptidase B and anionic trypsinogen as early predictors of severity of acute pancreatitis. Br J Surg 88:216–221
Sandberg AA, Borgstrom A (2002) Early prediction of severity in acute pancreatitis. Is it possible? JOP J Pancreas (Online) 3:116–125
Sainio V, Kemppainen E, Puolakkainen P, et al. (1995) Early antibiotic treatment in acute necrotising pancreatitis. Lancet 346:663–667
Messori A, Rampazzo R, Scrocaro G, et al. (1995) Effectiveness of gabexate mesilate in acute pancreatitis. A meta-analysis. Dig Dis Sci 40:734–738
Andriulli A, Leandro G, Clemente R, et al. (1998) Meta-analysis of somatostatin, octreotide and gabexate mesilate in the therapy of acute pancreatitis. Aliment Pharmacol Ther 12:237–245
Cavallini G, Frulloni L (2001) Somatostatin and octreotide in acute pancreatitis: the never-ending story. Dig Liv Dis 33:192–201
Wilson C, Heads A, Shenkin A, Imrie CW (1989) C-reactive protein, antiproteases and complement factors as objective markers of severity in acute pancreatitis. Br J Surg 76:177–181
Neoptolemos JP, Kemppainen EA, Mayer JM, et al. (2000) Early prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide: a multicentre study. Lancet 355:1955–1960
Acknowledgments
Preliminary data from this study were reported at the XXVII Meeting of the Italian Society for Pancreatic Study (AISP; Catania, Italy, September 18–20, 2003) and published as an abstract in Digestive and Liver Disease (35:S1–S12, 2003) and reported at the III Meeting of the Mediterranean Societies of Pancreatology (Santiago de Compostela, Spain, December 11–13, 2003) and published as abstract in Pancreatology (3:467–468, 2003).
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Carroccio, A., Rocco, P., Rabitti, P.G. et al. Plasma Calprotectin Levels in Patients Suffering from Acute Pancreatitis. Dig Dis Sci 51, 1749–1753 (2006). https://doi.org/10.1007/s10620-006-9078-4
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DOI: https://doi.org/10.1007/s10620-006-9078-4