Plasma Endothelin-1 Levels in Pancreatic Inflammations

Background. In inflammatory processes endothelin exerts an important effect on the pancreatic blood vessels and disturbances in pancreatic microcirculation. Objectives. The aim of the study was to evaluate the usefulness of plasma endothelin-1 (ET-1) levels in determining the severity of pancreatitis, its prognosis and monitoring the course of therapy. Material and Methods. The investigations were carried out on 115 subjects: 85 patients with pancreatitis and 30 persons serving as a control group. All the participants' ET-1 levels were determined by means of an enzymoimmunological test (Endothelin ETA Kit, Catalog No:583151, Cayman Chemical Company, Michigan, USA) on the 1st, 3rd, 5th and 7th days of treatment. In the control group, the mean ET-1 level was 1.37 pg/ml. Results. Acute pancreatitis (AP) was diagnosed in 53 patients, including 36 patients (67.9%) with severe AP. Their Ranson's scores were over 3 points. The highest mean plasma ET-1 levels were observed in 10 patients with severe AP with necrosis (6.37 +/- 1.9 pg/ml). (5 to 9 points on Ranson's scale). In 26 patients with severe AP without necrosis, the mean plasma ET-1 level was 3.49 +/- 1.24 pg/ml. In 17 patients with mild AP the mean plasma ET-1 level was 3.48 +/- 1.16 pg/ml (3 to 4 points on Ranson's scale). ET-1 levels normalized gradually with successful treatment. An increase in ET-1 levels between the 5th and 7th days was an unfavorable prognostic factor that was observed in all the patients who died. Conclusions. Measuring plasma ET-1 levels permits early determination of cases with severe AP. ET-1 can be used as a marker for both the progress of the disease and the efficacy of the treatment. An increase in plasma ET-1 level between the 5th and 7th days of treatment may indicate irreversible ischemic lesions in the pancreas and the development of necrotic lesions