Relationship of carotenoid and vitamins A and E with the acute inflammatory response in acute pancreatitis

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Abstract
Background: Inflammation and oxidative stress are believed to be important in the development of the systemic complications of acute pancreatitis. The fat-soluble vitamins A and E, and the carotenoids have antioxidant properties. The aim of this study was to assess the effect of acute pancreatitis on serum concentrations of vitamin antioxidants and to relate such changes to the degree of the inflammatory response. Methods: Thirteen consecutive patients with predicted severe acute pancreatitis were compared with 26 matched healthy controls. Five patients developed severe acute pancreatitis and three of these died. Vitamin antioxidant and C-reactive protein (CRP) levels were measured daily for up to 7 days. Results: Patients had significantly lower levels of antioxidants throughout the course of the study (P < 0·017). In patients there was a significant correlation between peak CRP and trough antioxidant levels (P < 0·01). In patients with mild acute pancreatitis, the concentrations of retinol and β-carotene at final review were significantly higher than those in patients with severe acute pancreatitis (P < 0·05). This coincided with a reduction in CRP level. Conclusion: In acute pancreatitis, circulating concentrations of vitamin antioxidants are reduced and are inversely related to the rise in CRP level.