Introduction. The mechanism of the immune system involvement in the pathogenesis of acute pancreatitis and exacerbation of chronic pancreatitis, especially regarding the influence of genes IL-1, IL-4, IL-6, TNF- polymorphism on the clinical evolution of edematous pancreatitis and the activity of pancreatic enzyme systems, is insufficiently studied.
Methods. We performed a biochemical study of certain pancreatic enzymes, by determining the activity of -amylase, pancreatic elastase-1 and trypsin. Molecular genetic study has been performed on 101 patients and included the definition of polymorphic variants of gene IL-4 (C-590T).
Results. The level of -amylase and trypsin was significantly higher in homozygous carriers of the C-variant C-590T polymorphism of gene IL-4 (for -amylase – 231.74 U/L vs. 133.94 U/L in mutation carriers, for trypsin – 2094.92 mkmol/L vs 1166.86 mkmol/L in homozygous T-allele owners) (Mann-Whitney criterion – 2.01, p<0.05 and 2.52, p<0.05, respectively). A higher concentration of pancreatic elastase-1 has been found in 12 patients with edematous pancreatitis: in 14.67% C-allele carriers and 3.85% of the T-allele owners of gene IL-4 (p>0.05). A weak correlation was found between the pancreatic elastase-1 blood content and AP if the mutation in positions 590 promoter of gene IL-4 (Sp-0.175; -0.173; p>0.05) is present.
Conclusions. The high content of -amylase and trypsin has occurred more often in the carriers of the C-allele of gene IL-4 (rs 2243250) by 39.44% (2 =12.02; p<0.001) and 38.87% (2 =13.26; p<0.001), respectively. The increased activity of -amylase and trypsin is a risk factor of edematous pancreatitis development in the carriers of the C-allele C-590T polymorphism of IL-4 gene (RR-0.266; 95%CI RR: 0.126-0.564; p<0.05 and RR-0.288; 95%CI RR: 0.183-0.565; p<0.05, respectively).
Key words: pancreatitis, polymorphism, gene, IL-4, -amylase, trypsin, pancreatic elastase-1.
Abbreviations: AP – acute pancreatitis; ECP – exacerbated chronic pancreatitis; IL-4 – interleukin 4; PCR – polymerase chain reaction
Sergiy Ivanovich Ivashchuk
Family Medicine Department, Bukovinian State Medical University
Heroyiv Maydanu str. 174/3, Chernivtsi, Ukraine 58029
Tel. +380503743544, e-mail: firstname.lastname@example.org