Interleukin-18 levels reflect the severity of acute pancreatitis

To examine the influence of interleukin (IL)-18 in acute pancreatitis from the points of view of the severity of the disease, presence of the complication of MODF and the prognosis, 17 patients with acute pancreatitis were enlisted. The IL-18 and TNF-α levels in the serum were determined by enzyme-linked immunosorbent assay. The levels of IL-18 were 4.3±5.3 pg/ml in the mild group, 18.7±67.1 pg/ml in the moderate group, and 269.6±2482.1 pg/ml in the severe group. The IL-18 levels increased significantly, corresponding to the severity of the disease. The group in which the complication of multiple organ dysfunction syndrome (MODS) developed showed significantly higher IL-18 levels than that in which this complication did not develop. The IL-18 levels in the survivor group were 132.0±130.7 pg/ml, and those in the nonsurvivor group were 3028.6±480.8 pg/ml, the levels being significantly higher in the nonsurvivor group. Significant correlations were observed between the maximum serum IL-18 and TNF-α levels. Significant correlations were observed between the total bilirubin and IL-18 levels. The results suggest that IL-18 may be used as a good indicator of severity of acute pancreatitis and that involved in the development of liver dysfunction in acute pancreatitis.