TH1 and TH2 Cytokine Profiles as Predictors of Severity in Acute Pancreatitis

Objectives Acute pancreatitis (AP) is severe in up to 20% of patients, with a high mortality rate. Quantification of serum TH1 and TH2 cytokines may provide objective evidence to assess the severity of AP and predict its course. Methods One hundred seventeen patients were studied, measuring serum concentrations of interleukin (IL)1, IL2, IL4, IL5, IL6, IL10, IL12p70, IL13, IL18, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon (IFN) , and tumor necrosis factor (TNF) . Results Significant differences were found between patients with severe AP and those with mild or moderately severe AP in IFN- (P < 0.001), IL6 (P < 0.001), TNF- (P = 0.002), GM-CSF (P < 0.001), IL4 (P = 0.002), IL1b (P = 0.017), and IL13 (P < 0.001) concentrations. Interferon-, IL6, and TNF- were associated with severe AP, whereas GM-CSF, IL4, IL1b, and IL13 were associated with mild or moderately severe AP. The IL13/IFN ratio was significantly higher in patients with mild AP (P = 7.36 x 10(-8)). Conclusions A TH1 profile was associated with severe AP and a TH2 profile with mild or moderately severe AP. We report an IL13/IFN ratio of potential value to predict the prognosis in AP.