The chemokine ligand CXCL16 is an indicator of bacterial infection in necrotizing pancreatitis

Pancreatology. 2015 Mar-Apr;15(2):124-30. doi: 10.1016/j.pan.2015.01.004. Epub 2015 Jan 23.

Abstract

Objectives: Current guidelines tell us that intervention in severe necrotizing pancreatitis ought to be performed as late as possible. However, when pancreatic necrosis becomes infected, the necrotic tissue needs to be removed. Unfortunately, bacterial infection can only be proven by invasive methods.

Methods: Necrotizing pancreatitis with sterile or infected necrosis was induced in mice. Mice serum samples were examined by antibody-based protein array. After identifying candidate proteins that showed strong regulation, the serum concentration of these proteins was examined by sandwich ELISA. Then, human serum samples were collected from patients with mild pancreatitis, severe pancreatitis with and without pancreatic necrosis and patients with microbiologically proven infection of pancreatic necrosis. These serum samples were then analyzed by sandwich ELISA.

Results: In mice 6 proteins were strongly up-regulated and were further investigated by ELISAs. Of these proteins, CXCL16 and TRANCE (RANKL) concentrations were analyzed in human serum samples. CXCL16 and TRANCE were increased in patients with pancreatic necrosis and abdominal infection. Receiver operated characteristics showed that CXCL16 was superior in predicting infected pancreatic necrosis when compared to C-reactive protein and TRANCE.

Conclusions: Serum CXCL16 is increased in severe pancreatitis with infected pancreatic necrosis and identifies patients who benefit from surgical necrosectomy.

Keywords: Biomarker; CXCL16; Chemokine; Infected necrosis; Infection; Mortality; Necrosis; Necrotizing pancreatitis; SIRS; Systemic inflammatory response syndrome.

MeSH terms

  • Adult
  • Animals
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / etiology*
  • Bacterial Infections / surgery
  • Biomarkers
  • C-Reactive Protein / analysis
  • Chemokine CXCL16
  • Chemokine CXCL6 / blood*
  • Chemokines, CXC / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Middle Aged
  • Pancreatectomy
  • Pancreatitis, Acute Necrotizing / complications*
  • Pancreatitis, Acute Necrotizing / surgery
  • Predictive Value of Tests
  • RANK Ligand / blood
  • Receptors, Scavenger / blood*
  • Up-Regulation

Substances

  • Biomarkers
  • CXCL16 protein, human
  • Chemokine CXCL16
  • Chemokine CXCL6
  • Chemokines, CXC
  • Cxcl16 protein, mouse
  • RANK Ligand
  • Receptors, Scavenger
  • C-Reactive Protein