Increased admission serum cold-inducible RNA-binding protein concentration is associated with prognosis of severe acute pancreatitis

Background: Cold-inducible RNA-binding protein (CIRP) is a pro-inflammatory cytokine. This study assessed its relation to disease severity and major adverse events (namely local complications, organ failure and in-hospital mortality) of severe acute pancreatitis (SAP) and its discriminatory ability for SAP.

Methods: This prospective and observational study recruited a total of 102 SAP patients, 48 patients with mild acute pancreatitis and 102 healthy individuals. Serum CIRP concentrations were determined using enzyme-linked immunosorbent assay.

Results: Serum CIRP concentrations were significantly higher in patients compared to controls. Serum CIRP concentrations were highly correlated with the circulating concentrations of common inflammatory mediators (i.e., procalcitonin, C-reactive protein and white blood cell) and the traditional predictors of disease severity (namely Acute Physiology and Chronic Health Care Evaluation II score, Ranson score, multiple organ dysfunction score and sequential organ failure assessment score). CIRP in serum was an independent predictor for major adverse events. Serum CIRP concentrations showed high predictive value for major adverse events, and possessed high discriminatory performance for SAP. Moreover, its effects significantly exceeded those of the preceding inflammatory mediators.

Conclusions: Increased serum CIRP concentrations clearly reflect SAP severity and prognosis and significantly distinguish SAP, substantializing CIRP as a potential SAP biomarker.