DYNAMIC MONITORING OF CPA1 AND CPA2 AS PREDICTORS OF SEVERITY AND OUTCOME IN ACUTE PANCREATITIS: A PROSPECTIVE COHORT STUDY drkksinghkgmu@gmail.com

 

DYNAMIC MONITORING OF CPA1 AND CPA2 AS PREDICTORS OF SEVERITY AND OUTCOME IN ACUTE PANCREATITIS: A PROSPECTIVE COHORT STUDY

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India

Oral only

Acute pancreatitis (AP) is a heterogeneous inflammatory condition of the pancreas, ranging from mild self-limiting disease to severe necrotizing forms with multi-organ dysfunction. Traditional biomarkers such as serum amylase and lipase aid in diagnosis but are suboptimal for predicting disease progression. Recent investigations suggest that pancreatic exopeptidases, Carboxypeptidase A1 (CPA1) and Carboxypeptidase A2 (CPA2), released early during acinar cell injury, may serve as dynamic indicators of disease activity. Their serial quantification could offer superior prognostic insight compared to static measurements or scoring systems alone.

In this prospective cohort study, 54 patients diagnosed with AP at a tertiary care centre in Northern India were enrolled based on established clinical, biochemical, and radiological criteria. Serial serum concentrations of CPA1 and CPA2 were measured on days 1, 3, 5, and 7 using ELISA. Disease severity was assessed using the Modified CT Severity Index (CTSI). Data were analysed using Wilcoxon signed-rank test, Mann–Whitney U test, and Pearson correlation coefficient; statistical significance was set at p < 0.05.

The cohort showed a mortality rate of 12.96%. Among survivors, CPA1 levels declined significantly from 589.86 IU/L to 463.56 IU/L (p = 0.0001), and CPA2 from 409.35 IU/L to 327.81 IU/L (p = 0.0399). Persistently elevated or rising enzyme levels were observed in non-survivors and patients with severe CTSI scores

Dynamic serial monitoring of CPA1 and CPA2 reflects the evolving severity of AP and correlates with clinical outcomes. These biomarkers show promise for early risk stratification and prognostication in acute pancreatitis.