MCP1 GENOTYPE IN ACUTE PANCREATITIS

Abstract

Introduction: Pancreatitis is closely associated with an intense inflammatory response. Monocyte chemotactic protein-1 (MCP-1) is a chemokine that plays a central role establishing and maintaining the inflammatory process. Polymorphism -2518 G of the regulatory region of monocyte MCP1 affects the level of expression of this chemokine increasing the inflammatory response. Aims: To determine whether: MCP1 2518 G allele is associated with the severity of acute pancreatitis (AP). MCP1 2518 G polymorphism is associated to acute recurrent pancreatitis (ARP). Patients and Methods: Determination of MCP1 2518 G polymorphism was achieved by PCR/Restriction Fragment Length Polymorphism (RFLP) in 101 patients affected from a single episode of biliary AP (59.4% Male); 67 patients affected from non-biliary acute recurrent pancreatitis (61.2% Male) and 73 healthy normal controls of the same ethnical group (56.3% Male). The severity of pancreatitis (AP + ARP) was based upon the Atlanta criteria: 129 patients had mild pancreatitis (76.8%), 39 had severe pancreatitis (23.2%). Results: MCP1 2518 G polymorphism is associated with ARP (Fisher's exact test, p = 0.003, OR = 2.74, CI = [1.42-5.30]). The heterozygous polymorphism 2518 G of MCP1 was found in 35 ARP patients (52.2%); the homozygous polymorphism 2518 G of MCP1 was found in 6 ARP patients (9.0%) and 26 ARP patients did not present the G allele (38.8%). The heterozygous polymorphism 2518 G of MCP1 was found in 46 AP patients (45.5%); the homozygous polymorphism 2518 G of MCP1 was found in 2 AP patients (2%) and 53 AP patients did not present the G allele (52.5%). The heterozygous polymorphism 2518 G of MCP1 was found in 21 normal controls subjects (28.8%); the homozygous polymorphism 2518 G of MCP1 was found in 5 controls (6.8%) and 47 controls did not present the G allele (64.4%). No statistically significance association has been observed between MCP1 2518 G polymorphism and single episode biliary AP. No statistically significance relationship between MCP1 2518 G polymorphism and severity of acute pancreatitis was detected. Conclusions: MCP-1 polymorphism is associated with ARP. This polymorphism could increase the inflammatory response leading to a recurrence of the disease and possibly to chronic pancreatitis. In our series the MCP-1 2518 G allele is not associated with the severity of AP.TABLE 1: MCP genotype in Acute Pancreatitis (AP) and Acute Recurrent Pancreatitis (ARP)TABLE 2: MCP Genotype in Mild Acute Pancreatitis (AP) and Severe Acute Pancreatitis (ARP)