Quantitative analysis of plasma DNA in severe acute pancreatitis.

CONTEXT Release of genomic DNA into plasma as a result of necrotic and apoptotic pathways is a feature of a range of human tumours. Severe acute pancreatitis is characterized by inflammation but may also be associated with accelerated apoptotic and necrotic pathways. OBJECTIVES This study uses quantitative real-time PCR to measure free circulating DNA in patients with severe acute pancreatitis. PARTICIPANTS Forty-three patients with severe acute pancreatitis, 12 patients with pancreatic cancer and 28 non-cancer controls undergoing laparoscopic cholecystectomy. METHODS Plasma DNA was purified and quantified using the RNase P transcription assay and quantitative PCR. In pancreatitis patients, baseline samples were taken on admission and further samples taken at a median of 5 days into the disease course. RESULTS Plasma DNA levels on admission in patients with acute pancreatitis (median: 0.40 ng/microL; range: 0.05-0.79 ng/microL) were significantly (P<0.001) lower than in non-cancer controls (median: 1.60 ng/microL; range: 0.45-9.10 ng/microL). In patients with acute pancreatitis, DNA levels significantly (P<0.001) fell during the disease course to a median value of 0.08 ng/microL (range: 0-0.53 ng/microL). CONCLUSION This is the first study to use quantitative PCR to measure free plasma DNA in severe acute pancreatitis. The results show that plasma DNA is lower in patients with acute pancreatitis compared to control and that values fall further during the disease course.