Different profiles of cytokine expression during mild and severe acute pancreatitis

Figure 3 Cytokine expression at mRNA and protein level in peripheral blood of patients with mild and severe AP. A: Gene expression in peripheral blood leukocytes of MAP and SAP patients. QRT-PCR analysis revealed that SAP is characterized by significantly decreased intracellular mRNA levels of interleukin (IL)-1 and interferon (IFN)-γ. SAP is also associated with markedly lower mRNA expression levels of CD25 and CD69 in peripheral blood leukocytes. However, severe and necrotizing pancreatitis was associated with a very high activation of neutrophils and macrophages as demonstrated by nearly ten-fold higher mRNA expression of elastase and myeloperoxidase in peripheral white blood cells (WBCs). A significantly lower mRNA expression of ICAM-1 and macrophage migration inhibitory factor (MIF) was observed in peripheral WBCs (but not in the blood serum) from patients with SAP compared to that of MAP group. Cytokine mRNA expression levels with statistically significant differences between MAP and SAP groups are depicted; B: Cytokine concentration in blood serum of MAP and SAP patients. Analysis of cytokine expression at protein levels shows that SAP is associated with a typical systemic inflammatory response syndrome (SIRS) and 2-5 fold increase in expression of pro-inflammatory cytokines (IL-6, IL-8, MIF). Induction of a compensatory and regulatory mechanism (IL-10) is also observed in this group. Up to 4-5 fold higher levels of LTB4 were recorded in patients who died during the early stages of the disease. Cytokine expression levels with statistically significant differences between AP and healthy control groups are shown.