Chitotriosidase and neopterin as biomarkers in acute cholecystitis
EAES Academy. Mois E. 07/05/22; 363187; P251
Emil Mois
Contributions
Contributions
Abstract
Aims:
Gallstones are a common benign surgical pathology, twice as common for females. About 10-20% of the world's population will develop gallstones during lifetime and about 80% will be asymptomatic. Chitotriosidase and neopterin can be considered to evaluate the inflammation as products of macrophage activation. We aimed to evaluate the differences in chitotriosidase activity and neopterin levels between chronic and acute cholecystitis, and the influence of laparoscopic cholecystectomy invasiveness on postoperative biomarker variations. Methods: A prospective cohort study was conducted from August 2019 to January 2021. Patients with laparoscopic surgery for gallstones at the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, that gave their informed consent, were considered eligible. Blood samples were collected on EDTA (ethylenediaminetetraacetic acid) at presentation and at 24 hours after surgery. Patients with biliary pancreatitis, cholestasis, cholangitis, reactive hepatitis, abnormal renal function or conversion to the classical procedure were excluded. Intraoperative appearance and the pathology report were used to determine the type of cholecystitis (atrophic or chronic cholecystitis vs catarrhal or gangrenous or phlegmonous cholecystitis with wall erosions and ulcerations). Results: Fifty-one subjects with gallstones (thirty-six with chronic cholecystitis and fifteen with acute cholecystitis) were included in the study. A significantly higher level was observed at baseline for neopterin: 16.82 (13.53-21.36) nmol/L in acute cases vs. 11.91 (6.8-16.39) nmol/L for chronic cholecystitis (p=0.019 – Mann Whitney test). There were no significant differences for chitotriosidase activity: 160 (110-212.5) nmol/mL/h in chronic cholecystitis vs. 170 (90-295) nmol/mL/h for acute cholecystitis (p=0.664 – Mann Whitney test). When comparing the pre-postoperative values, no significant changes were observed after the laparoscopic intervention for neopterin [13.03 (7.77-18.34) nmol/L vs. 12.25 (8.84-20.62) nmol/L], neither for chitotriosidase [170 (110-230) nmol/mL/h vs 140 (110-195) nmol/mL/h]. Also no significant differences were observed in the postoperative values for neopterin neither for chitotriosidase regarding some additional invasive maneuvers: drainage, incision and aponeurosis enlargement, adhesiolysis or surgery time over 60 minutes. Conclusions: Subjects with acute cholecystitis have a significantly higher neopterin level at presentation than those with chronic cholecystitis. Chitotriosidase and neopterin levels reveal no significant changes at 24 hours after the laparoscopic approach.
Gallstones are a common benign surgical pathology, twice as common for females. About 10-20% of the world's population will develop gallstones during lifetime and about 80% will be asymptomatic. Chitotriosidase and neopterin can be considered to evaluate the inflammation as products of macrophage activation. We aimed to evaluate the differences in chitotriosidase activity and neopterin levels between chronic and acute cholecystitis, and the influence of laparoscopic cholecystectomy invasiveness on postoperative biomarker variations. Methods: A prospective cohort study was conducted from August 2019 to January 2021. Patients with laparoscopic surgery for gallstones at the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, that gave their informed consent, were considered eligible. Blood samples were collected on EDTA (ethylenediaminetetraacetic acid) at presentation and at 24 hours after surgery. Patients with biliary pancreatitis, cholestasis, cholangitis, reactive hepatitis, abnormal renal function or conversion to the classical procedure were excluded. Intraoperative appearance and the pathology report were used to determine the type of cholecystitis (atrophic or chronic cholecystitis vs catarrhal or gangrenous or phlegmonous cholecystitis with wall erosions and ulcerations). Results: Fifty-one subjects with gallstones (thirty-six with chronic cholecystitis and fifteen with acute cholecystitis) were included in the study. A significantly higher level was observed at baseline for neopterin: 16.82 (13.53-21.36) nmol/L in acute cases vs. 11.91 (6.8-16.39) nmol/L for chronic cholecystitis (p=0.019 – Mann Whitney test). There were no significant differences for chitotriosidase activity: 160 (110-212.5) nmol/mL/h in chronic cholecystitis vs. 170 (90-295) nmol/mL/h for acute cholecystitis (p=0.664 – Mann Whitney test). When comparing the pre-postoperative values, no significant changes were observed after the laparoscopic intervention for neopterin [13.03 (7.77-18.34) nmol/L vs. 12.25 (8.84-20.62) nmol/L], neither for chitotriosidase [170 (110-230) nmol/mL/h vs 140 (110-195) nmol/mL/h]. Also no significant differences were observed in the postoperative values for neopterin neither for chitotriosidase regarding some additional invasive maneuvers: drainage, incision and aponeurosis enlargement, adhesiolysis or surgery time over 60 minutes. Conclusions: Subjects with acute cholecystitis have a significantly higher neopterin level at presentation than those with chronic cholecystitis. Chitotriosidase and neopterin levels reveal no significant changes at 24 hours after the laparoscopic approach.
Aims:
Gallstones are a common benign surgical pathology, twice as common for females. About 10-20% of the world's population will develop gallstones during lifetime and about 80% will be asymptomatic. Chitotriosidase and neopterin can be considered to evaluate the inflammation as products of macrophage activation. We aimed to evaluate the differences in chitotriosidase activity and neopterin levels between chronic and acute cholecystitis, and the influence of laparoscopic cholecystectomy invasiveness on postoperative biomarker variations. Methods: A prospective cohort study was conducted from August 2019 to January 2021. Patients with laparoscopic surgery for gallstones at the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, that gave their informed consent, were considered eligible. Blood samples were collected on EDTA (ethylenediaminetetraacetic acid) at presentation and at 24 hours after surgery. Patients with biliary pancreatitis, cholestasis, cholangitis, reactive hepatitis, abnormal renal function or conversion to the classical procedure were excluded. Intraoperative appearance and the pathology report were used to determine the type of cholecystitis (atrophic or chronic cholecystitis vs catarrhal or gangrenous or phlegmonous cholecystitis with wall erosions and ulcerations). Results: Fifty-one subjects with gallstones (thirty-six with chronic cholecystitis and fifteen with acute cholecystitis) were included in the study. A significantly higher level was observed at baseline for neopterin: 16.82 (13.53-21.36) nmol/L in acute cases vs. 11.91 (6.8-16.39) nmol/L for chronic cholecystitis (p=0.019 – Mann Whitney test). There were no significant differences for chitotriosidase activity: 160 (110-212.5) nmol/mL/h in chronic cholecystitis vs. 170 (90-295) nmol/mL/h for acute cholecystitis (p=0.664 – Mann Whitney test). When comparing the pre-postoperative values, no significant changes were observed after the laparoscopic intervention for neopterin [13.03 (7.77-18.34) nmol/L vs. 12.25 (8.84-20.62) nmol/L], neither for chitotriosidase [170 (110-230) nmol/mL/h vs 140 (110-195) nmol/mL/h]. Also no significant differences were observed in the postoperative values for neopterin neither for chitotriosidase regarding some additional invasive maneuvers: drainage, incision and aponeurosis enlargement, adhesiolysis or surgery time over 60 minutes. Conclusions: Subjects with acute cholecystitis have a significantly higher neopterin level at presentation than those with chronic cholecystitis. Chitotriosidase and neopterin levels reveal no significant changes at 24 hours after the laparoscopic approach.
Gallstones are a common benign surgical pathology, twice as common for females. About 10-20% of the world's population will develop gallstones during lifetime and about 80% will be asymptomatic. Chitotriosidase and neopterin can be considered to evaluate the inflammation as products of macrophage activation. We aimed to evaluate the differences in chitotriosidase activity and neopterin levels between chronic and acute cholecystitis, and the influence of laparoscopic cholecystectomy invasiveness on postoperative biomarker variations. Methods: A prospective cohort study was conducted from August 2019 to January 2021. Patients with laparoscopic surgery for gallstones at the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, that gave their informed consent, were considered eligible. Blood samples were collected on EDTA (ethylenediaminetetraacetic acid) at presentation and at 24 hours after surgery. Patients with biliary pancreatitis, cholestasis, cholangitis, reactive hepatitis, abnormal renal function or conversion to the classical procedure were excluded. Intraoperative appearance and the pathology report were used to determine the type of cholecystitis (atrophic or chronic cholecystitis vs catarrhal or gangrenous or phlegmonous cholecystitis with wall erosions and ulcerations). Results: Fifty-one subjects with gallstones (thirty-six with chronic cholecystitis and fifteen with acute cholecystitis) were included in the study. A significantly higher level was observed at baseline for neopterin: 16.82 (13.53-21.36) nmol/L in acute cases vs. 11.91 (6.8-16.39) nmol/L for chronic cholecystitis (p=0.019 – Mann Whitney test). There were no significant differences for chitotriosidase activity: 160 (110-212.5) nmol/mL/h in chronic cholecystitis vs. 170 (90-295) nmol/mL/h for acute cholecystitis (p=0.664 – Mann Whitney test). When comparing the pre-postoperative values, no significant changes were observed after the laparoscopic intervention for neopterin [13.03 (7.77-18.34) nmol/L vs. 12.25 (8.84-20.62) nmol/L], neither for chitotriosidase [170 (110-230) nmol/mL/h vs 140 (110-195) nmol/mL/h]. Also no significant differences were observed in the postoperative values for neopterin neither for chitotriosidase regarding some additional invasive maneuvers: drainage, incision and aponeurosis enlargement, adhesiolysis or surgery time over 60 minutes. Conclusions: Subjects with acute cholecystitis have a significantly higher neopterin level at presentation than those with chronic cholecystitis. Chitotriosidase and neopterin levels reveal no significant changes at 24 hours after the laparoscopic approach.
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