Harnessing early enzymatic biomarkers and cytokines for risk prediction in post-endoscopic retrograde cholangiopancreatography pancreatitis

Table 1 Role of cytokine biomarkers in the prediction of severe post-endoscopic retrograde cholangiopancreatography pancreatitis[24,26-30,32,35,36,42,43]

Cytokine	Cytokine type	Clinical utility	Detection method	Assay limitations
IL-6	Pro- and anti-inflammatory	(1) Peaks 12-24 hours post-ERCP in severe cases[24,29]; (2) Peaks within 6-24 hours, earlier than CRP and PCT[27,28]; and (3) Cut-off 196.6 pg/mL in SAP. Sensitivity 81.8%, specificity 91.3%, and AUC = 0.882[30]	Chemiluminescence[26,32]; ELISA[24,29]	High cost
TNF-α	Pro-inflammatory	(1) Elevated at 12 hours in patients with complicated post-ERCP pancreatitis[29]; and (2) Cut-off 0.07 pg/mL in SAP. Sensitivity 63.6%, specificity 61.8%, and AUC = 0.562[30]	ELISA[29,43]	Labor-intensive and time-consuming
IL-8	Pro-inflammatory chemokine	(1) Early predictor of pre-ERCP pancreatitis development[32]; and (2) Cut-off 1.46 pg/mL in SAP. Sensitivity 72.7%, specificity 73.1%, and AUC = 0.700[30]	Chemiluminescence[32]; ELISA[43]	High cost
IL-10	Anti-inflammatory	(1) Associated with ERCP-related factors[28]; (2) Conflicting results regarding preventive potential in post-ERCP pancreatitis after IL-10 administration[35,36]; (3) Potential predictor of treatment response[42]; and (4) Cut-off 9.54 pg/mL in SAP. Sensitivity 72.7%, specificity 93.3%, and AUC = 0.762[30]	ELISA[28,43]	Labor-intensive and time-consuming

ERCP: Endoscopic retrograde cholangiopancreatography; IL: Interleukin; TNF-α: Tumor necrosis factor-alpha; CRP: C-reactive protein; PCT: Procalcitonin; ELISA: Enzyme-linked immunosorbent assay; AUC: Area under curve; SAP: Severe acute pancreatitis.