Relationship Between Acute Severe Pancreatitis and Mitochondrial DNA
Relationship Between Acute Severe Pancreatitis and Mitochondrial DNA
Plasma mtDNA analysis aids in predicting pancreatic necrosis in severe acute pancreatitis
 patients.After the onset of severe acute pancreatitis, pancreatic necrosis and the content of
 mtDNA in plasma will increase, showing a significant positive correlation.
Acute pancreatitis is an acute inflammatory disease of the pancreas characterized by the
 sudden onset of abdominal pain, elevated serum amylase, and edema or necrosis of the
 pancreas. The clinical course of AP is generally mild; however, nearly 25% of patients
 progress into severe AP which consists of organ failure and/or pancreatic necrosis. Although
 advances in the diagnosis and management have been made, AP remains a major health issue to
 the society. PNec is a major complication of AP which manifests as non-opacified parenchyma
 with intravenous contrast, as identified via contrast-enhanced CT scan. Patients with PNec
 are more likely to develop pancreatic infection and suffer a greater risk for mortality .
 Currently, CECT scans remain the "gold standard" to diagnosis PNec clinically. However, the
 extent of PNec is best seen about 3 days after the presentation of disease and may be missed
 in early CT scan. In addition, repeated CT scanning is not convenient to monitor changes in
 necrosis, most notably for those who are receiving mechanical ventilation or
 hemofiltration.The clinical diagnosis of AP is based on the presence of the following
 features: abdominal pain; serum amylase and/or lipase levels three times higher than the
 upper limit of normal; and characteristic findings of AP on CT scan.

 Specific plasma biomarkers in predicting pancreatic necrosis (PNec) are needed in treating
 acute pancreatitis (AP). Aims To investigate the prognostic value of plasma mitochondrial DNA
 fragments (mtDNA) in patient with AP for PNec. Methods AP patients with symptoms onset within
 72 h were prospectively enrolled.The conclusions elevated plasma mtDNA content in AP patients
 may be used as a more accurate early predictor of PNec in contrast to traditional CRP.

 Normally,human mtDNA is strictly contained in mitochondria and not exposed to the innate
 immune system even following cell apoptosis. However, in times of cell death elicited by
 stress (e.g., trauma and sepsis), mtDNA is released into systemic circulation and leads to an
 array of inflammatory reactions. Elevated mtDNA levels have been reported in a variety of
 clinical situations, including trauma, severe sepsis, and cancer. As PNec is caused by
 intracellular activation of digestive enzymes and autodigestion, we assumed that circulating
 mtDNA levels could be used as a biomarker for early detection of PNec.

 Research methods and steps:cell culture and mtDNA extraction、mtDNA detection、statistical
 analysis、results.
Inclusion Criteria:

 -  Clinical diagnosis of severe acute pancreatitis

 -  Admission time less than two days

 Exclusion Criteria:

 -  Malignant Tumor

 -  Positive confirmed pregnancy or urinary pregnancy test

 -  Acute liver failure

 -  Immunosuppressive state

 -  Hormone use

 -  Transplantation

 -  Death within seven days

 -  Blood transfusion over 1000ml in seven days

 -  Missing Visits

 -  Incomplete information

 -  Family Requirements