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Clinical and Developmental Immunology
Volume 2008, Article ID 481560, 7 pages
http://dx.doi.org/10.1155/2008/481560
Research Article

Do the Changes in the Serum Levels of IL-2, IL-4, TNF , and IL-6 Reflect the Inflammatory Activity in the Patients with Post-ERCP Pancreatitis?

1Department of Gastroenterology, Gulhane Military Medical Academy, School of Medicine, Etlik, 06010 Ankara, Turkey
2Department of Immunology, Gulhane Military Medical Academy, School of Medicine, Etlik, 06010 Ankara, Turkey
3Department of Internal Medicine, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey

Received 11 December 2007; Revised 25 March 2008; Accepted 2 June 2008

Academic Editor: Shyam Mohapatra

Copyright © 2008 Guldem Kilciler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP) procedure and there are some reports showing cytokine changes in ERCP-induced pancreatits. Goals. To investigate the association between early changes (within 24 hours) in the serum interleukin (IL)-2, IL-4, tumor necrosis factor (TNF) , and IL-6 levels and the development of post-ERCP pancreatitis. Study. Forty five consecutive patients who underwent therapeutic ERCP and 10 patients with acute pancreatitis without ERCP were enrolled to the study. Serum concentrations of IL-2, IL-4, TNF , and IL-6 were determined immediately before, 12 hours and 24 hours after ERCP. Results. Seven of the 45 patients (15.5%) developed post-ERCP pancreatitis. The levels of IL-4 at 24 hours after ERCP were significantly lower in the patients with post-ERCP pancreatitis than in those without pancreatitis, while TNF levels at 12 hours after ERCP were higher in the complicated group than those of the uncomplicated group. The ratios of TNF /IL-4 at 12 and 24 hours after ERCP were found significantly higher in the patients with post-ERCP pancreatitis than in those without pancreatitis. IL-6 in the complicated patients was found significantly increased at 24 hours after ERCP. Conclusions. The enhancement of serum TNF and IL-6 levels in the patients with ERCP-induced pancreatitis reflects the inflammatory activity. Additionally, these cytokines together with IL-4 can be used in clinical laboratory monitoring of ERCP.