Dugernier, Thierry L
Laterre, Pierre-François
[UCL]
Wittebole, Xavier
Roeseler, Jean
[UCL]
Latinne, Dominique
[UCL]
Reynaert, Marc
[UCL]
Pugin, Jérôme
Local and systemic inflammation has been implicated in the pathogenesis of acute pancreatitis and secondary multisystem organ failure. To assess the pro- and antiinflammatory response, the site of mediator production, and their route of diffusion, we sampled simultaneously ascites, thoracic lymph, and blood at the onset of end-organ dysfunction and for the following 6 days in 60 patients with acute pancreatitis. We used immunoassays to measure pro- and antiinflammatory cytokines and cell-based bioassays to assess the net pro- and antiinflammatory activity elicited by the biological fluids. Tumor necrosis factor-alpha and interleukin-1beta were detected in less than 15% of blood and lymph samples. Secondary pro- and antiinflammatory cytokines were found to be elevated early and throughout the sampling period in all compartments. Cytokine levels decreased from ascites to lymph to blood, suggesting a splanchnic origin. Prolonged diversion of ascites and lymph did not alter cytokine gradients, suggesting mediator transfer via the splanchnic blood circulation. Although a net proinflammatory activity ascribed to interleukin-1beta was detected in ascites, a net antiinflammatory activity was measured in virtually all lymph and blood samples, suggesting that the pancreas and the splanchnic area are sites of a proinflammatory response and that an early, dominant, and sustained antiinflammatory activity takes place in circulating compartments.
Bibliographic reference |
Dugernier, Thierry L ; Laterre, Pierre-François ; Wittebole, Xavier ; Roeseler, Jean ; Latinne, Dominique ; et. al. Compartmentalization of the inflammatory response during acute pancreatitis: correlation with local and systemic complications.. In: American journal of respiratory and critical care medicine, Vol. 168, no. 2, p. 148-57 (2003) |
Permanent URL |
http://hdl.handle.net/2078.1/26320 |