ASSOCIATION OF ACUTE INFLAMMATORY MARKERS, OXIDATIVE STRESS MARKERS, AND PRO-INFLAMMATORY GENE EXPRESSION IN PATIENTS WITH CHRONIC PANCREATITIS
Abhina Mohanan*, Biju Pottakkat
Gastro Enterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India
Aim: In this study, we aimed to elucidate the molecular mechanisms in the development of inflammatory pathways in chronic pancreatitis (CP); we compared the serum levels of inflammatory and oxidative stress markers in Chronic Pancreatitis (CP) patients and healthy controls and pro-inflammatory gene expression of tumor necrosis factor-alpha (TNF-α), Nuclear Factor kappa B (NFk-β), interleukin-6 (IL-6), and cyclooxygenase-2 (COX-2) were also compared with controls.
Method: This prospective study included participants with CP (n=45) between 18 -65 years. 45 healthy controls were also recruited. Serum biochemical and oxidative stress parameters viz, TAO, TOS, and MDA were measured. OSI index was calculated. Pancreatic tissues for gene expression study were collected from patients operated on for CP (n=25/45). Control tissues were obtained from patients who underwent surgery for carcinoma pancreas from the non-affected normal part of the pancreas (n=30). Real-time polymerase chain reaction (RT-PCR) was performed using extracted RNAs. Fold change was calculated relative to the controls using the 2-ddct formula.
Results: There were no significant differences in age and gender. Though the presenting symptom of all the patients was pain, none had a recent acute pain episode or elevated serum amylase levels. In our study group, none of the women were alcoholics. Leukocytosis and increased LFT were observed in cases. All oxidative stress parameters were significantly increased in patients compared to the control (Table 1). The median fold changes of TNF-α, NFk-β, and Cox-2 were significantly higher than controls (Table 2).
Conclusion: Our study observed the increased inflammatory process and oxidative stress in patients with CP compared with healthy controls. Upregulation of pro-inflammatory genes occurs in CP. Oxidative damage, usually associated with acute inflammation, is observed in patients with CP. All these findings of our study point to the fact that recurrent acute inflammation happens in patients with CP. This acute inflammation might be a significant contributor to the development and progression of the disease in patients with CP.
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