Evaluation of serum high mobility group box-1 andcalcipressin-1 levels in patients diagnosed with acutepancreatitis in the emergency department

Acute pancreatitis is a condition characterized by inflammation of the pancreas and surrounding tissues due to the activation of pancreatic enzymes. It typically presents with severe abdominal pain, nausea, and vomiting. Diagnosis is made through clinical evaluation, elevated levels of amylase and lipase, and radiological findings. While 80% of acute pancreatitis cases are mild, 20% are severe. Severe pancreatitis carries a high risk of mortality and morbidity. Calcipressin1 is a protein that temporarily prevents apoptosis in cells at low levels of oxidative stress. It has been shown to play a role in diseases such as cardiac hypertrophy, atherosclerotic diseases, Down syndrome, and Alzheimer's disease. High mobility group box 1 (HMGB1) senses and coordinates the cellular stress response. It typically increases in pathogenic inflammatory conditions, as well as in cancer, sepsis, and autoimmunity. Our study aimed to investigate the value of these biomarkers in the diagnosis and severity assessment of acute pancreatitis. Our study was conducted with 64 patients diagnosed with acute pancreatitis and 24 healthy control subjects. The average age of the 88 participants in our study was 51.8±16.8 years, with 59.1% being female and 40.9% male. The average Calcipressin1 levels were found to be 9.24±7.20 ng/ml in the patient group and 4.83±3.62 ng/ml in the healthy group. The average levels of High Mobility Group Box 1 (HMGB1) were 2940.72±739.68 pg/ml in the patient group and 2131.65±968.62 pg/ml in the healthy group. Both biomarkers were elevated in the patient group compared to healthy individuals. While no relationship was found between HMGB1 and BISAP, Ranson, and Imrie scores, a relationship was detected between Calcipressin1 and Ranson and Imrie scores. Platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, systemic inflammatory index, creatinine, blood urea nitrogen (BUN), and C-reactive protein were higher in patients with severe pancreatitis compared to those without severe pancreatitis. For the diagnosis of severe pancreatitis, blood urea nitrogen was found to be the most valuable parameter, with an AUC value of 0.909. In conclusion, Calcipressin1 and High Mobility Group Box 1 (HMGB1) levels were found to be helpful in diagnosing acute pancreatitis. However, these biomarkers were not significant in determining the severity of acute pancreatitis. We believe that larger-scale studies with more samples could provide more information on predicting the severity of acute pancreatitis.