Angiopoietin-2 Is an Early Predictor for Acute Gastrointestinal Injury and Intestinal Barrier Dysfunction in Patients with Acute Pancreatitis

Backgrounds Angiopoietin-2 (Ang-2) is a new predictor for acute pancreatitis (AP). Aims To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). Methods This was a prospective study that enrolled 170 patients with AP and 100 he...

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Veröffentlicht in:Digestive diseases and sciences 2021, Vol.66 (1), p.114-120
Hauptverfasser: Huang, Qing, Wu, Zhe, Chi, Cheng, Wu, Chunbo, Su, Lin, Zhang, Yuanyuan, Zhu, Jihong, Liu, Yulan
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container_issue 1
container_start_page 114
container_title Digestive diseases and sciences
container_volume 66
creator Huang, Qing
Wu, Zhe
Chi, Cheng
Wu, Chunbo
Su, Lin
Zhang, Yuanyuan
Zhu, Jihong
Liu, Yulan
description Backgrounds Angiopoietin-2 (Ang-2) is a new predictor for acute pancreatitis (AP). Aims To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). Methods This was a prospective study that enrolled 170 patients with AP and 100 healthy controls. Blood samples were collected within 24 h of the onset of AP. Results The majority (108) of the patients were categorized as having MAP with the rest (62) classified as suffering from SAP. Considering AGI grading, there were 118 grade 1 and 12 grade 4 patients; in grades 2 and 3, there were 20 patients each. AP was accompanied by MODS and pancreatic necrosis in 46 and 24 cases, respectively. Eighty patients were admitted to the ICU, while mortality was reported among 7.1% patients. The plasma Ang-2 levels were higher among patients with AP than in controls. A similar trend prevailed, in patients with SAP compared to those with MAP. Ang-2 was significantly increased from AGI grade 1 through to grade 4, showing a desirable positive predictive accuracy. Moreover, Ang-2 also showed strong correlations with intestinal permeability as evaluated by d-lactate (DLA), diamine oxidase (DAO), and intestinal fatty acid binding proteins (I-FABPs). Tools (Ranson and APACHE II scores, CRP), which are used more conventionally, could not effectively distinguish the various grades of AGI. Furthermore, Ang-2 predicted poor prognosis and adverse outcomes, including mortality, among patients with AP. Conclusions This study showed Ang-2 to be an accurate early predictor for SAP, AGI, and intestinal barrier dysfunction, outperforming conventional biomarkers. Ang-2 levels also predicted the adverse outcomes and mortality due to AP.
doi_str_mv 10.1007/s10620-020-06138-0
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Aims To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). Methods This was a prospective study that enrolled 170 patients with AP and 100 healthy controls. Blood samples were collected within 24 h of the onset of AP. Results The majority (108) of the patients were categorized as having MAP with the rest (62) classified as suffering from SAP. Considering AGI grading, there were 118 grade 1 and 12 grade 4 patients; in grades 2 and 3, there were 20 patients each. AP was accompanied by MODS and pancreatic necrosis in 46 and 24 cases, respectively. Eighty patients were admitted to the ICU, while mortality was reported among 7.1% patients. The plasma Ang-2 levels were higher among patients with AP than in controls. A similar trend prevailed, in patients with SAP compared to those with MAP. Ang-2 was significantly increased from AGI grade 1 through to grade 4, showing a desirable positive predictive accuracy. Moreover, Ang-2 also showed strong correlations with intestinal permeability as evaluated by d-lactate (DLA), diamine oxidase (DAO), and intestinal fatty acid binding proteins (I-FABPs). Tools (Ranson and APACHE II scores, CRP), which are used more conventionally, could not effectively distinguish the various grades of AGI. Furthermore, Ang-2 predicted poor prognosis and adverse outcomes, including mortality, among patients with AP. Conclusions This study showed Ang-2 to be an accurate early predictor for SAP, AGI, and intestinal barrier dysfunction, outperforming conventional biomarkers. Ang-2 levels also predicted the adverse outcomes and mortality due to AP.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-020-06138-0</identifier><identifier>PMID: 32193858</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Acute Disease ; Adult ; Aged ; Angiopoietin-2 - blood ; Angiopoietin-2 - metabolism ; Binding proteins ; Biochemistry ; Biomarkers ; Biomarkers - blood ; Care and treatment ; Disease ; Early Diagnosis ; Fatty acids ; Female ; Gastroenterology ; Gastrointestinal Diseases - blood ; Gastrointestinal Diseases - diagnosis ; Health aspects ; Hepatology ; Humans ; Intestinal Mucosa - metabolism ; Intestinal Mucosa - pathology ; Male ; Medical research ; Medicine ; Medicine &amp; Public Health ; Medicine, Experimental ; Middle Aged ; Mortality ; Multiple organ dysfunction syndrome ; Normal distribution ; Oncology ; Original Article ; Pancreatitis ; Pancreatitis - blood ; Pancreatitis - diagnosis ; Patients ; Permeability ; Predictive Value of Tests ; Prospective Studies ; Protein binding ; Transplant Surgery</subject><ispartof>Digestive diseases and sciences, 2021, Vol.66 (1), p.114-120</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>COPYRIGHT 2021 Springer</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-80c4828833482e7adb65b266975a5dc09d1bf75be503ae04a0f941d8e2da89d63</citedby><cites>FETCH-LOGICAL-c442t-80c4828833482e7adb65b266975a5dc09d1bf75be503ae04a0f941d8e2da89d63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-020-06138-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-020-06138-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27915,27916,41479,42548,51310</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32193858$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Qing</creatorcontrib><creatorcontrib>Wu, Zhe</creatorcontrib><creatorcontrib>Chi, Cheng</creatorcontrib><creatorcontrib>Wu, Chunbo</creatorcontrib><creatorcontrib>Su, Lin</creatorcontrib><creatorcontrib>Zhang, Yuanyuan</creatorcontrib><creatorcontrib>Zhu, Jihong</creatorcontrib><creatorcontrib>Liu, Yulan</creatorcontrib><title>Angiopoietin-2 Is an Early Predictor for Acute Gastrointestinal Injury and Intestinal Barrier Dysfunction in Patients with Acute Pancreatitis</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Backgrounds Angiopoietin-2 (Ang-2) is a new predictor for acute pancreatitis (AP). Aims To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). Methods This was a prospective study that enrolled 170 patients with AP and 100 healthy controls. Blood samples were collected within 24 h of the onset of AP. Results The majority (108) of the patients were categorized as having MAP with the rest (62) classified as suffering from SAP. Considering AGI grading, there were 118 grade 1 and 12 grade 4 patients; in grades 2 and 3, there were 20 patients each. AP was accompanied by MODS and pancreatic necrosis in 46 and 24 cases, respectively. Eighty patients were admitted to the ICU, while mortality was reported among 7.1% patients. The plasma Ang-2 levels were higher among patients with AP than in controls. A similar trend prevailed, in patients with SAP compared to those with MAP. Ang-2 was significantly increased from AGI grade 1 through to grade 4, showing a desirable positive predictive accuracy. Moreover, Ang-2 also showed strong correlations with intestinal permeability as evaluated by d-lactate (DLA), diamine oxidase (DAO), and intestinal fatty acid binding proteins (I-FABPs). Tools (Ranson and APACHE II scores, CRP), which are used more conventionally, could not effectively distinguish the various grades of AGI. Furthermore, Ang-2 predicted poor prognosis and adverse outcomes, including mortality, among patients with AP. Conclusions This study showed Ang-2 to be an accurate early predictor for SAP, AGI, and intestinal barrier dysfunction, outperforming conventional biomarkers. 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Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multiple organ dysfunction syndrome</topic><topic>Normal distribution</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pancreatitis</topic><topic>Pancreatitis - blood</topic><topic>Pancreatitis - diagnosis</topic><topic>Patients</topic><topic>Permeability</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Protein binding</topic><topic>Transplant Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Qing</creatorcontrib><creatorcontrib>Wu, Zhe</creatorcontrib><creatorcontrib>Chi, Cheng</creatorcontrib><creatorcontrib>Wu, Chunbo</creatorcontrib><creatorcontrib>Su, Lin</creatorcontrib><creatorcontrib>Zhang, Yuanyuan</creatorcontrib><creatorcontrib>Zhu, Jihong</creatorcontrib><creatorcontrib>Liu, Yulan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Aims To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). Methods This was a prospective study that enrolled 170 patients with AP and 100 healthy controls. Blood samples were collected within 24 h of the onset of AP. Results The majority (108) of the patients were categorized as having MAP with the rest (62) classified as suffering from SAP. Considering AGI grading, there were 118 grade 1 and 12 grade 4 patients; in grades 2 and 3, there were 20 patients each. AP was accompanied by MODS and pancreatic necrosis in 46 and 24 cases, respectively. Eighty patients were admitted to the ICU, while mortality was reported among 7.1% patients. The plasma Ang-2 levels were higher among patients with AP than in controls. A similar trend prevailed, in patients with SAP compared to those with MAP. Ang-2 was significantly increased from AGI grade 1 through to grade 4, showing a desirable positive predictive accuracy. Moreover, Ang-2 also showed strong correlations with intestinal permeability as evaluated by d-lactate (DLA), diamine oxidase (DAO), and intestinal fatty acid binding proteins (I-FABPs). Tools (Ranson and APACHE II scores, CRP), which are used more conventionally, could not effectively distinguish the various grades of AGI. Furthermore, Ang-2 predicted poor prognosis and adverse outcomes, including mortality, among patients with AP. Conclusions This study showed Ang-2 to be an accurate early predictor for SAP, AGI, and intestinal barrier dysfunction, outperforming conventional biomarkers. Ang-2 levels also predicted the adverse outcomes and mortality due to AP.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32193858</pmid><doi>10.1007/s10620-020-06138-0</doi><tpages>7</tpages></addata></record>
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subjects Acute Disease
Adult
Aged
Angiopoietin-2 - blood
Angiopoietin-2 - metabolism
Binding proteins
Biochemistry
Biomarkers
Biomarkers - blood
Care and treatment
Disease
Early Diagnosis
Fatty acids
Female
Gastroenterology
Gastrointestinal Diseases - blood
Gastrointestinal Diseases - diagnosis
Health aspects
Hepatology
Humans
Intestinal Mucosa - metabolism
Intestinal Mucosa - pathology
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Mortality
Multiple organ dysfunction syndrome
Normal distribution
Oncology
Original Article
Pancreatitis
Pancreatitis - blood
Pancreatitis - diagnosis
Patients
Permeability
Predictive Value of Tests
Prospective Studies
Protein binding
Transplant Surgery
title Angiopoietin-2 Is an Early Predictor for Acute Gastrointestinal Injury and Intestinal Barrier Dysfunction in Patients with Acute Pancreatitis
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