Diagnosis and Immunoassay for Acute Pancreatitis

The number of people getting acute pancreatitis in the United States is increasing on the basis of the current average of 275,000 hospital admissions annually. Most patients admitted with pancreatitis have mild symptoms and can be discharged within a few days. However, 0.6% to 5.6% of patients could relapse, and the mortality of acute pancreatitis reaches approximately 2%. Therefore, the demand for accurate and rapid diagnosis, resuscitation, evaluation, and management of acute pancreatitis is looming.

Introduction to Acute Pancreatitis

Acute pancreatitis is an acute response that develops quickly after injury of the pancreas, with common symptoms like abdominal pain, vomiting, fever, and dehydration. When acute pancreatitis happens, digestive chemicals, enzymes made in the pancreas, are activated after they reach the part of the gut and start to 'digest' parts of the pancreas, leading to a wide range of chemical reactions that cause inflammation in the pancreas.

Possible Damages of Pancreatitis

Different from chronic pancreatitis that possibly results in permanent damage to the structure and endocrine and exocrine functions of the pancreas, most acute pancreatitis cases have a mild inflammation that disappears shortly, while in some severe acute pancreatitis cases, pancreatic chemicals (enzymes) may get into the bloodstream and other organs, leading to shock, respiratory failure, kidney failure, and other fatal complications.

Diagnostics of Acute Pancreatitis

Though with some obvious symptoms, they are non-specific to acute pancreatitis. Acute pancreatitis diagnostics should go further with a combination of history and examination, laboratory investigations of pancreatic enzyme, and radiological evidence of pancreatic inflammation. Biomarkers, including trypsinogens, phospholipase A2, pancreatic elastase, urine trypsinogen activated protein (TAP), and carboxypeptidase B (CAPB), are anticipated to improve the diagnostic accuracy of acute pancreatitis, especially for in vitro diagnostic (IVD) tests based on antibodies.

In vitro diagnostic antibodies against specific disease biomarkers are widely used to detect diseases, infections, and other pathological conditions. Trypsinogen, an inactive precursor of trypsin, is a promising indicator for the early diagnosis and prognosis of inflammatory pancreatitis. Studies have proven that intrapancreatic activation of trypsinogen 2 to trypsin plays a crucial role in the pathogenesis of acute pancreatitis. Therefore, the development of IVD antibodies against trypsinogen-2 is essential for the prognosis, diagnosis, and therapeutic monitoring of pancreatitis.

Tests based on the detection and quantification of antigens or antibodies in samples, such as serum, plasma, urine, and saliva, are known as immunoassays. To satisfy the increasingly high need for diagnosis of acute pancreatitis, a lot of contract research organizations (CRO), for example, Creative Biolabs, are dedicated to developing immunoassay kits and validating different immunoassays, including lateral flow immunoassays and ELISA tests.

Treatment

The main tasks of treating acute pancreatitis are reduction of inflammation and aggressive fluid resuscitation. In addition, treatment may involve painkiller injection, nutrition feedings, cholecystectomy during the admission, insulin drips, etc. depending on the severity of acute pancreatitis attack.

To decrease the possibility of the readmission of acute pancreatitis, patients should accept alcohol and smoking cessation, especially for those admitted to the hospital with pancreatitis due to alcohol. It's reported that about 40% of such inflammation is caused by gallstones while heavy alcohol drinking accounts for 30% of etiology. Moreover, emphasis should also be put on dietary and lifestyle modifications, including weight reduction, low-fat diet, and regular exercise.

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