Monocyte chemoattractant protein 1, active carboxypeptidase B and CAPAP at hospital admission are predictive markers for severe acute pancreatitis

Pancreatology. 2008;8(1):42-9. doi: 10.1159/000114866. Epub 2008 Jan 31.


Background: CAPAP, the activation peptide of procarboxypeptidase B, is a predictor of severe acute pancreatitis (AP). Active carboxypeptidase (aCAP) may be a better predictor, as its turnover is slower. Monocyte chemotactic protein-1 (MCP-1) is an early inflammatory marker and increases before complications in severe AP. We conducted a cohort study to evaluate these markers as predictors for severe AP.

Method: 140 patients with AP were included, retrospectively grouped as severe or mild by the Atlanta classification. CAPAP, MCP-1 and aCAP were analyzed in admission samples. Receiver operating characteristic curves determined high vs. low levels.

Results: The levels of all markers were significantly higher in patients with severe disease. High levels of serum MCP-1 was associated with a high risk of developing severe AP (OR 40.8; 95% CI 8.5-195). High ORs were also seen for urine MCP-1 (OR 7.3; 95% CI 2.2-24.3), serum CAPAP (OR 5.4; 95% CI 1.6-17.7), urine CAPAP (OR 4.8; 95% CI 1.6-14.2), and serum aCAP (OR 3.7; 95% CI 1.2-11.3).

Conclusion: Serum MCP-1 at admission was strongly associated with development of severe AP. MCP-1 in urine, CAPAP in serum and urine and aCAP may also be useful for predicting severe AP. and IAP.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Carboxypeptidase B / blood*
  • Chemokine CCL2 / blood*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis / blood*
  • Peptides / blood*
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Severity of Illness Index


  • Biomarkers
  • Chemokine CCL2
  • Peptides
  • carboxypeptidase B activation peptide
  • Carboxypeptidase B