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

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Abstract

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.

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Acknowledgments

We thank Jiangyuan Wang for the assistance in data analysis and Zhaopeng Zhang, Jiayang Liu, and the nursing team of gastroenterology and emergency department of Peking University People’s Hospital for the blood sample collection. This project (RD 2016-29) was supported by Peking University People’s Hospital Research and Development Funds.

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Authors and Affiliations

  1. Department of Gastroenterology, Peking University People’s Hospital, Beijing, China

    Qing Huang, Zhe Wu, Lin Su, Yuanyuan Zhang & Yulan Liu

  2. Department of Emergency, Peking University People’s Hospital, Beijing, China

    Cheng Chi, Chunbo Wu & Jihong Zhu

Authors
  1. Qing Huang
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  2. Zhe Wu
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  3. Cheng Chi
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  4. Chunbo Wu
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  5. Lin Su
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  6. Yuanyuan Zhang
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  7. Jihong Zhu
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  8. Yulan Liu
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Correspondence to Yulan Liu.

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The authors declare that they have no conflict of interest.

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The study was approved by the Ethics Committee of Peking University People’s Hospital. All the patients enrolled in the study were well informed and signed the informed consents.

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Huang, Q., Wu, Z., Chi, C. et al. Angiopoietin-2 Is an Early Predictor for Acute Gastrointestinal Injury and Intestinal Barrier Dysfunction in Patients with Acute Pancreatitis. Dig Dis Sci 66, 114–120 (2021). https://doi.org/10.1007/s10620-020-06138-0

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  • DOI: https://doi.org/10.1007/s10620-020-06138-0

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