The Clinical Value of Human Pancreas-Specific Protein Procarboxypeptidase B as an Indicator of Necrosis in Acute Pancreatitis

Rau, Bettina; Cebulla, Martin; Uhl, Waldemar; Schoenberg, M. H.; Beger, H. G.

doi:10.1097/00006676-199808000-00004

Cited by 39 publications

(17 citation statements)

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“…19 The specific CAPAP assay reported here gives an accuracy of 92% (AUC 0.920) in this respect. The specific proCAPB assay however cannot differentiate pancreatic necrosis from oedematous pancreatitis (AUC 0.565).…”

Section: Extent Of Necroses (%)mentioning

confidence: 72%

Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases

Muller¹,

Appelros

Uhl³

et al. 2002

Gut

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Background: Carboxypeptidase B from the pancreatic gland may exist in three different molecular and immunoreactive forms: the proenzyme, the active enzyme, and the activation peptide. Aims: To investigate levels of procarboxypeptidase B (proCAPB) and its activation peptide in serum in acute pancreatitis to test the accuracy of these two variables as markers for the diagnosis of acute pancreatitis and for prediction of pancreatic necrosis. To elucidate whether leakage of proenzymes and activation of proenzymes reflect two different pathophysiological events in acute pancreatitis. Methods: Sera from patients with acute pancreatitis (n=85) and acute abdominal pain of non-pancreatic origin (n=53) were analysed for proCAPB and its activation peptide. Patients with pancreatitis were divided into necrotising (n=33) and oedematous attacks (n=52) using contrast enhanced computed tomography. Accuracy was determined using receiver operating characteristic curve analysis. Results: Immunoreactive carboxypeptidase B activation peptide (ir-CAPAP) concentration in serum on admission was 0.7 nmol/l (0-18.1) in patients with oedematous pancreatitis compared with 5.8 nmol/l (1.9-34) in patients with later development of pancreatic necrosis. Elevated levels of the activation peptide on admission correlated with an accuracy of 92% to later development of pancreatic necrosis. Ir-proCAPB concentration in serum on admission was 16.0 nmol/l (1.4-50.5) in all patients with acute pancreatitis versus 0.3 nmol/l (0-3.6) in patients with non-pancreatic acute abdominal disorders. Cases with oedematous pancreatitis had ir-proCAPB levels of 15.4 nmol/l (1.4-50.5) versus 19.1 nmol/l (2.7-36.1) in cases with later development of pancreatic necrosis. Measurement of the proenzyme can thus be useful for the diagnosis of acute pancreatitis (accuracy 99%) but levels did not correlate with later development of pancreatic necrosis (accuracy 56%). Conclusion: Leakage of proenzymes occurs in acute pancreatitis, irrespective of severity, while development of pancreatic necrosis occurs only when there is activation of the proenzymes.

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Section: Extent Of Necroses (%)mentioning

confidence: 72%

Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases

Muller¹,

Appelros

Uhl³

et al. 2002

Gut

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show abstract

“…These results could be explained by a delay in the measurement of IL-6 and MCP-1 given that the samples were taken within the first 24 h of admission without taking into account the time between the onset of symptoms and admission. It is known that the peak in the cytokines appears during the first 48 h after the onset of symptoms, while the prediction of severity through the CRP levels has maximum validity at 72 h from the onset of symptoms [7,46] . The discrepancy between the results of Papachristou's work and ours could be explained because we measured the levels of cytokines at a different moment taking into account the real time of the evolution of the disease.…”

Section: Discussionmentioning

confidence: 99%

Obesity and Fat Distribution Imply a Greater Systemic Inflammatory Response and a Worse Prognosis in Acute Pancreatitis

et al. 2008

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“…Because its elevation persisted longer than the two other enzymes, its determination may be useful for diagnosis in the late phase (68). Moreover, procarboxypeptidase B values are higher in necrotizing pancreatitis than in the edematous form of the disease by Day 3 (69).…”

Section: Products Released By the Pancreasmentioning

confidence: 99%

New Serum Markers for the Detection of Severe Acute Pancreatitis in Humans

Frossard

Hadengue

Pastor

2001

Am J Respir Crit Care Med

106

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The Clinical Value of Human Pancreas-Specific Protein Procarboxypeptidase B as an Indicator of Necrosis in Acute Pancreatitis

Cited by 39 publications

References 0 publications

Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases

Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases

Obesity and Fat Distribution Imply a Greater Systemic Inflammatory Response and a Worse Prognosis in Acute Pancreatitis

New Serum Markers for the Detection of Severe Acute Pancreatitis in Humans

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