The Clinical Research For The Changes Of Serum Angiogenin-2 And Endogenous Resolvin E1 In Patients With Acute Pancreatitis

Background and PurposeInstability vascular endothelial cell structure make large amounts of fluid lost from the unstable vascular bed in the early stages of acute pancreatitis (AP), vascular bed erosion causes vasodilation leading to drop of blood pressure. Patients usually need to early rehydration, monitoring of organ function, and to be transferred to the intensive cwere unit in 12 to 24 hours for severe acute pancreatitis (SAP). Therefore, early diagnosis of pancreatitis has important significance to control the disease progression. At the same time early assessment in the severity acute pancreatitis got more and more attention. Ang-2(angiogenin-2) is the natural antagonists of Ang-1, can promote the vascular endothelial cells survive, early serum Ang-21evel is a potential biomarker for severity judgment and prognosis of acute pancreatitis. Clinical research show that the SAP patients serum Ang-21evels increased significantly compared with mild patients, serum Ang-21evel has important value in SAP patients, but the relationship between Ang-2and the severity of pancreas injury in AP patients has not been reported, we tested serum Ang-21evel in AP patients, and investigate the relationship between Ang-2and pancreas CT severity index, and significance for the severity of pancreatic tissue damage in AP patients. Resolvin is a kind of endogenous lipid anti-inflammatory medium, derived from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), including ResolvinEl (RvEl), ResolvinD (RvD1),etc. Resolvin can restrain the infiltration and activation of inflammatory cells, inhibit inflammation in the cell signal transcription, thereby inhibiting the generation and release of cytokines and chemokines, has the effect to inhibit inflammation. A number of basic and clinical research suggests that RvEl inhibit inflammation, but serum RvEl level whether changes in AP patients were not reported, we test serum RvE1 level in AP patients and to explore the relationship between RvE1 andand pancreatic CT severity index. Serum D-lactic acid (D-LA) can reflect the intestinal mucosal injury and permeability change, can be used as serum marker for evaluation of intestinal mucous membrane permeability in AP patients, so we test the serum D-LA for reflecting the severity of AP. This project aims to obseRvEl Ang-2and RvEl expression in acute pancreatitis patients, analyze and evaluate the clinical significance of Ang-2and RvEl for the severity acute pancreatitis.MethodThirty-four AP cases were included, fifteen cases of chronic gastritis patients and fifteen healthy adults were included as control group. AP patients were divided into SAP patients (seven cases) and MAP patients (twenty-seven cases) according to the severity of AP. General information and clinical data were collected carefully. Fasting venous blood were collected in the morning in health adults, and in the morning of the first day in chronic gastritis patients at the time of hospitalization, while fasting venous blood were collected in the morning on lth day and 10th day in MAP and SAP patients at the time of hospitalization, respectively. Use ELISA kit to test serum Ang-2, RvEl and D-LA level separately. AP patients got pancreatic CT scan for evaluation of severity of AP, and chronic gastritis patients got CT scan at the time of hospitalization.ResultSerum Ang-2, RvEl and D-LA level had no difference (P all>0.05) in healthy adults compared with chronic gastritis patients. Serum Ang-2, RvEl and D-LA level were significantly higher (P all< 0.05) in AP patients compared with healthy adults and chronic gastritis patients, and increased more significantly in SAP patients (P all< 0.05). After ten days treatment, serum Ang-2, RvEl and D-LA levels had no significant change (P all> 0.05) in AP patients compared with those of pre-treatment, but were still significantly higher (P all< 0.05)compared with healthy adults and chronic gastritis patients. Serum Ang-21evels (1th day and 10th day)and RvE1(1th day and 10th day) levels were positively correlated (r= 0.58, r= 0.48; P all< 0.001), and serum Ang-2 levels were positively correlated with serum D-LA levels in 1th day and 10th day(r=0.67, r=0.33, P all<0.001). Serum RvEl levels were positively correlated with serum D-LA levels in lth day and 10th day(r=0.86, r=0.77, P all<0.001). Ang-2, RvE1 levels were positively correlated with CT severity index (r= 0.65, r= 0.63; P all< 0.001).ConclusionSerum Ang-2, RvE1, D-LA levels were significantly elevated in AP patients especially in SAP patients. Serum Ang-2, RvE1 levels were positively correlated with serum D-LA and CT severity index. The change of serum Ang-2, RvE1 can reflect the severity of inflammation in AP patients, and can be used as potential biomarker for severity judgment for acute pancreatitis.