Systemic inflammation contributes to impairment of quality of life in chronic pancreatitis

Abstract

Chronic pancreatitis (CP) is a fibrotic disorder of the pancreas leading to clinical sequelae like pain and an excess of comorbidity including cardiovascular disease and cancers. The aim of this study was to determine the relationship between systemic inflammation and quality of life in patients with CP. Patients were prospectively recruited and underwent a quality of life assessment (EORTC QLQ-C30 and PAN 28). The serum inflammatory profile was assessed using an MSD 30-plex array. The relationship between clinical variables, inflammatory cytokines and quality of life was determined by a GLM-MANOVA and the individual impact of significant variables evaluated by a second ANOVA. In total, 211 patients with a median age of 53 years were recruited across 5 European centres. Gender, age, nicotine and alcohol abuse were clinical variables associated with altered quality of life. Systemic inflammation with high levels of pro-inflammatory cytokines (Eotaxin, IL-1β, IL-7, IL-8, IL-12/IL-23p40, IL-12p70, IL-13, IL-16, IP-10, MCP-1, MCP-4, MDC, MIP-1a, TARC, TNFß) was associated with diminished quality of life in general and specific domains including pain, physical and cognitive functioning. As conclusion, CP is associated with a systemic inflammatory response that has a negative impact on quality of life and accelerates aging.

Dietary inflammatory index is associated with pain intensity and some components of quality of life in patients with knee osteoarthritis

“…To our knowledge, our study is the first that examined the relationship between DII score and scales and subscales of QOL. However, the association of systemic inflammation with high levels of inflammatory and pro-inflammatory cytokines with reduced QOL in general and specific components including pain, physical and emotional health have been shown in previous studies [ 36 – 39 ].…”

Suboptimal care for chronic pancreatitis patients revealed by moderate to low adherence to the United European Gastroenterology evidence‐based guidelines (HaPanEU): A Netherlands nationwide analysis

“…12,13 Other factors that negatively influence QoL are a lower body weight, longer disease duration, pancreatic exocrineand endocrine-insufficiency, systemic inflammation, persistent smoking and unemployment. 7,11,14,15 Management of CP is difficult and involves many domains of health care. 12 Due to the lack of an evidence-based national guideline in the past, clinical decision-making in CP was mostly based on the experience, beliefs and disbeliefs of the local clinician, presumptively leading to a large variation in the level of care delivered to patients in the Netherlands.…”

“…Pain is reported in around 90% of the CP patients and about half of those patients will continue to have pain, despite therapy, adversely influencing their QoL 12 , 13 . Other factors that negatively influence QoL are a lower body weight, longer disease duration, pancreatic exocrine‐ and endocrine‐insufficiency, systemic inflammation, persistent smoking and unemployment 7 , 11 , 14 , 15 …”

Immunological Responses to Envenomation

“…These include cytokines (IL-1β, IL-6, TNF, IFN-γ, IL-10, IL-12, and GM-CSF) and chemokines (IL-8, MCP-1, eotaxin/CCL11, IP-10/CXCL10, MDC/CCL22, MIP-1α, and TARC/CCL17), as well as bradykinin, eicosanoids (prostaglandins and leukotrienes), cyclooxygenases, NO, and histamine ( 84 ). Dysregulation of these mediators is associated with inflammatory and neuropathic pain ( 85 , 86 ), tissue destruction ( 87 ), systemic inflammation ( 88 – 90 ), autoimmunity, and allergic reactions ( 91 ). Unsurprisingly, the same proteins are detected in the serum of victims of envenomation, where pain and systemic injury occur ( 92 , 93 ).…”