Selectin-L and PECAM-1 in Acute Pancreatitis

The adhesion molecules Selectin-L and PECAM-1 play an important role in acute inflammation and especially in acute pancreatitis. The aim of this book is to spreads the results of a randomized clinical trial (RCT) that investigate the potential changes of their concentrations in blood serum of the patients with acute pancreatitis. The above study included 150 patients with acute pancreatitis, any etiology and severity, and 70 healthy volunteers - controls with similar - matched epidemiological features. Recorded age, gender, etiology, severity according to the Atlanta criteria, and the Glasgow criteria, and the outcome. Also measured the concentrations of molecules Selectin-L and PECAM-1 in blood serum of the healthy controls and the patients at the time of admission, and after 24, 48 and 120 hours. The concentrations of the adhesion molecules Selectin-L and PECAM-1 in blood serum of the patients with acute pancreatitis altered, reduced and increased significantly respectively, compared to controls (P <0.001). The concentrations of Selectin-L are a predictive tool to Atlanta severity, with 70.2% sensitivity and 48.7% specificity, 48 hours after admission (P = 0.009), but also can predict the heaviest 5th scale of Glasgow criteria (P <0.001). Variations of both adhesion molecules from the time of admission, at 24, 48 and 120 hours after, were not significant (P = NS). The laboratory evaluation of adhesion molecules Selectin-L and PECAM-1 in blood serum represent a useful diagnostic tool of acute pancreatitis. Even more, the values of Selectin-L constitute a prognostic marker of the severity of acute pancreatitis.

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TABLE OF CONTENTS PROLOGUE III THANKS IV GENERAL PART 1. ACUTE PANCREATITIS 1 1.1 Chronology 1 1.2 Definition - Impact - Classification 1 1.3 Etiopathology 3 1.4. Pathology 5 1.5 Etiology 5 1.5.1 Gallstones 5 1.5.2 Alcohol consumption 7 1.5.3 Medicinal Pancreatitis 9 1.5.4 Acute Pancreatitis after ERCP 9 1.5.5 Hypercalcemia 10 1.5.6 Familial Pancreatitis 10 1.5.7 Obstruction 11 1.5.8 Various other reasons 12 1.5.9 Idiopathic Pancreatitis 12 1.6 Pathophysiology 13 1.7 Clinical Picture 17 1.8 Diagnosis and Differential Diagnosis 18 1.9 Natural History and Mortality 22 1.10 Staging and Prognosis 23 1.11 Therapeutical Approaches 25 2. ACUTE INFLAMMATION AND ADHESION MOLECULES 31 2.1 Mai