Evaluation of the prognostic role of inflammatory markers: Tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) - in patients with acute pancreatitis

Acute pancreatitis is one of the poorly understood common acute digestive tract disorders. It is not just difficult to diagnose, even the severity of the disease is often underestimated. Early in the course of pancreatitis, pro-inflammatory agents can release more cytokines like TNF-α and IL-6 into the pancreatic tissue and serum, thereby amplifying the local and systemic inflammatory response. In the present study, 50 patients diagnosed on the basis of routine investigations, imaging techniques and history as having acute non-traumatic pancreatitis and falling between Ranson's criteria 2 and 6, were studied. They were divided into Groups I, II and III with Ranson's criteria of 3, 4 and 5 respectively. In addition to routine investigations, serum Interleukin-6 (IL-6) and Tumour Necrosis Factor (TNF-α) values were measured on the day of admission, after 48 hours and on the seventh day. A control group of 20 patients with pain abdomen of non-pancreatic origin were investigated, studied and closely followed up simultaneously. Alcohol was found to be the major positive factor (60%), with gallstones found in 28%. Both IL-6 and TNF-α were significantly increased in patients with acute pancreatitis as compared to patients of non-pancreatic pain abdomen. The levels were significantly higher in Group III when compared with Groups I and II. Although values of IL-6 and TNF-α are increased significantly, they do not play any significant role in predicting the outcome of acute pancreatitis. Since our study was on a small scale and as our patients reached after wasting interventional time, a prospective study on a much larger scale, without any disadvantage of the time factor would be a welcome effort in this field of vast possibilities.