Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001339 (acute pancreatitis)
 10,593 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hemorrhagic shock caused by gastrointestinal bleeding in seven pigs and by external bleeding in another six pigs and cardiogenic shock induced by intravenous infusion of the tricyclic antidepressant drug nortriptyline in yet another eight pigs caused a significant increase in serum cationic trypsin-like immunoreactivity together with formation of complexes between cationic trypsin, on the one hand, and alpha-2-macroglobulin and alpha-1-antitrypsin, on the other hand, compatible with what happens in acute pancreatitis.
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PMID:Effect of hemorrhagic and nortriptyline-induced shock on the porcine pancreas as evaluated by changes in serum cationic trypsin-like immunoreactivity. 241 78

For a period of 14 days we carried out measurements for alpha-1-protease inhibitor, alpha-2-macroglobulin, complement C 3, complement C 4, and C-reactive protein in two different groups of patients with acute pancreatitis. Group I consisted of 13 patients with edematous-interstitial pancreatitis and group II of 22 patients with necrotizing pancreatitis. Diagnosis of acute pancreatitis was established by clinical signs and symptoms, by specific pancreatic enzymes determined in the serum, by imaging procedures, and by laparotomy in 24 cases. The overall detection rate for pancreatic necrosis was 90% for the contrast enhanced CT and 33% for ultrasonography respectively. There were significant differences as to all measured serum parameters between the two morphologically defined pancreatitis groups. The necrosis detection rate was 95% for CRP and 85% for alpha-2-macroglobulin. The combined determination of CRP and alpha-2-macroglobulin is recommended in patients with acute pancreatitis to stage the severity of the disease and to probably replace the CT investigation.
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PMID:[Value of biochemical and imaging procedures for the diagnosis and prognosis of acute pancreatitis--results of a prospective clinical study]. 242 94

Thirty-five patients with acute pancreatitis underwent serum monitoring of alpha-1-protease inhibitor, alpha-2-macroglobulin, complement factors C3 + C4, and C-reactive protein (CRP). Edematous interstitial pancreatitis was shown to be present in 13 patients by contrast-enhanced computed tomography (CT) and laparotomy (n = 3). Necrotizing pancreatitis was confirmed by laparotomy (n = 21) and contrast-enhanced CT. There were significant differences between the serum values of all measured parameters in the two morphologically defined pancreatitis groups. The best discriminating factors were CRP and alpha-2-macroglobulin, showing 95% and 85% overall detection rates for pancreatic necrosis, respectively.
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PMID:Sensitivity of antiproteases, complement factors and C-reactive protein in detecting pancreatic necrosis. Results of a prospective clinical study. 244 67

The most important diagnostic step in the management of patients with severe acute pancreatitis is the discrimination between acute interstitial and necrotizing pancreatitis. Measurement of C-reactive protein, lactic acid dehydrogenase, alpha-1-antitrypsin, and alpha-2-macroglobulin and contrast-enhanced CT are useful in detecting the necrotizing course of acute pancreatitis. C-reactive protein, lactic acid dehydrogenase, and contrast-enhanced CT offer detection rates of 85 per cent to more than 90 per cent for pancreatic necrosis. Surgical decision-making in necrotizing pancreatitis should be based on clinical, morphologic, and bacteriologic data. Patients with focal pancreatic necrosis, in general, respond well to medical treatment and do not need surgery. Extended (50 per cent or more) pancreatic necroses, infected necroses, and intrapancreatic parenchymal necroses plus extrapancreatic fatty tissue necroses are indicators for surgical management. The decision for the timing of operation in patients with proved necrotizing pancreatitis should be based on clinical criteria: the development of an acute surgical abdomen, generalized sepsis, shock, persisting or increasing organ dysfunction, or some combination thereof despite maximum intensive care treatment for at least 3 days. Major pancreatic resection for the treatment of necrotizing pancreatitis appears disadvantageous. Necrosectomy and continuous local lavage allow debridement of devitalized tissue and preservation of vital pancreatic tissue. Postoperative local lavage thus results in an atraumatic evacuation of necrotic tissue, the bacterial material, and biologically active substances. The hospital mortality rate of patients treated with necrosectomy and continuous local lavage (the Ulm protocol) is below 10 per cent. Nevertheless, controlled prospective clinical trials should be performed in order to bring more precision to our clinical decisions in respect to the role of surgery for this disease.
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PMID:Surgical management of necrotizing pancreatitis. 265 62

Serum trypsin, total trypsin-inhibitor capacity, alpha-1-antitrypsin and alpha-2-macroglobulin were analyzed daily in ten patients hospitalized as a result of acute pancreatitis. Markedly raised serum trypsin concentrations were found in all patients. Alpha-1-antitrypsin and the trypsin-inhibitor capacity were also significantly increased as compared to post-illness values, but alpha-2-macroglobulin tended to decrease during acute pancreatitis. The post-illness values of all these parameters were in the normal range. It is concluded that a deficiency of alpha-1-antitrypsin, trypsin-inhibitor capacity of alpha-2-macroglobulin is not present in patients with acute pancreatitis which could render the pancreas more vulnerable to its own proteases. During acute pancreatitis trypsin is released into the circulation, but it is effectively inactivated by serum protease inhibitors, mainly alpha-1-antitrypsin, which can be seen as an increased trypsin-inhibitor capacity in these patients. The use of protease inhibitors in the treatment of acute pancreatitis seems to be unnecessary against this background. Increased serum trypsin values can be used when confirming the diagnosis of acute pancreatitis.
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PMID:Serum immunoreactive trypsin and trypsin inhibitors during acute pancreatitis. 616 88

Most attacks of acute pancreatitis are mild and self-limiting. In 10-20% of the cases, however, severe disease with multiple systemic complications develops. During the last few years it has been recognized that activated leukocytes have an important role in the multisystem involvement during acute pancreatitis. Activated leukocytes are thus a pathogenetic factor in the severity of the disease. Activation of polymorphonuclear granulocytes (PMNs) and of monocytes/macrophages is an early event during severe acute pancreatitis. Factors released by activated leukocytes therefore reflect the severity of the disease. Three independent studies have shown that released PMN-elastase is a reliable early prognostic marker that permits correct classification of 80-95% of the patients within the first 24-48 hours. Interleukin-6 (IL-6), mainly secreted by activated monocytes/macrophages, is also an early prognostic parameter (shown in one study), but is not superior to PMN-elastase. Leukocyte activation markers are more reliable than multiple scoring systems in the assessment of the severity of acute pancreatitis. Compared with PMN-elastase or IL-6, increased plasma concentrations of such acute-phase proteins as alpha-1-antitrypsin or CRP, and consumption of the protease inhibitor alpha-2-macroglobulin, are later events that can be detected only 1 to 4 days later. Comparison of the various inflammatory parameters suggests that PMN-elastase is the best early and reliable prognostic marker in acute pancreatitis. The reviewed data underscore the role of activated leukocytes in the pathogenesis of complicated acute pancreatitis.
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PMID:Inflammatory mediators and cytokines--new aspects of the pathophysiology and assessment of severity of acute pancreatitis? 750 68

Immunoreactive cationic pancreatic elastase (irPE) in serum and peritoneal exudate from 8 patients with severe acute pancreatitis was found mainly in complex with alpha-1-proteinase-inhibitor (alpha 1PI). Only minor amounts of irPE were found in a molecular form corresponding to the free proenzyme. The presence of alpha-2-macroglobulin (alpha 2M)-bound, elastase-like activity in the exudates indicates that active elastase was bound to this inhibitor. The results indicate that pancreatic cationic elastase is released to some extent as active enzyme in acute pancreatitis. However, no free elastolytic activity was present in the exudates.
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PMID:Human cationic, pancreatic elastase in acute pancreatitis. 768 Aug 23

Severe acute pancreatitis (SAP) is a common acute clinical abdomen syndrome which is characterized by pancreatic self-digestion. As one of the major complication of SAP, acute lung injury is the main reason of high mortality. The traditional Chinese medicine Qingyi pellet (QYT) has been widely used for SAP in clinic. In our study, we constructed the severe acute pancreatitis-associated lung injury (SAP-ALI) rat model and treated with QYT, then characterized the protein from the lung tissue by using a mass spectrometry-based proteomic strategy. Our results showed that, in the SAP group, 9 proteins exhibited obvious changes according to the proteomic analysis. Among the 9 proteins, 7 proteins (alpha-2-macroglobulin, Cathepsin S, ras-related protein RAP-1A, integrin beta, protein phosphatase 2A, Intercellular adhesion molecule 1 and p38) were up-regulated, and 2 proteins (adapter molecule Crk and stathmin) were down-regulated. Interestingly, the data of the QYT group showed that adapter molecule Crk and stathmin were up-regulated, but the other 7 proteins were down-regulated. The kyoto encyclopedia of genes shows that the proteins act on PI3K-AKT, chemokine signaling pathways, apoptosis, leukocyte transendothelial migration and focal adhesion. Therefore, the therapeutic effects of QYT on SAP-ALI are potentially through the additive and/or synergistic interactions of numerous components.
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PMID:Proteomic analysis of therapeutic effects of Qingyi pellet on rodent severe acute pancreatitis-associated lung injury. 3154 48