Cytokine profile in prediction of acute lung injury in patients with acute pancreatitis

Objectives: To study the role of cytokines in prediction of acute lung injury (ALI) in acute pancreatitis. Methods: Levels of TNF alpha, IL-6, IL-10, IL-8 and IL-1 beta were measured in 107 patients at presentation and at 72 h in patients who developed acute lung injury. A model was devised to predict development of ALI using cytokine levels and SIRS score. Results: The levels of TNF alpha (p <0.0001), IL-6 (p <0.0001), IL-8 (p <0.0001) and IL-1 beta (p <0.0001) were significantly higher in the ALI group. IL-10 levels were significantly lower in persistent ALI (p-ALI) than in transient ALI (t-ALI) patients (p <0.038). p-ALI group had significant rise of TNF alpha (p = 0.019) and IL-10 (p = 0.001) while t-ALI group had significant rise of only IL-1 beta (p = 0.044) on day 3 vs day 1. Combined values of IL-6 and IL-8 above 251 pg/ml had sensitivity of 90.9% and a specificity of 100% to predict future development of ALI. Composite marker-I (IL6 >= 80 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 98% whereas composite marker-II (IL8 >= 100 pg/ml + SIRS) yielded sensitivity and specificity of 73% and 95% to predict future ALI. Conclusions: IL-6 and IL-8 can predict future development of ALI. When they are combined with SIRS, they can be used as comprehensive composite markers. (C) 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.