Original article Association between antioxidants and mild acute pancreatitis Tevfik Solakoglu a,⇑ , Huseyin Koseoglu b , Semra Isikoglu c , Ozcan Erel d , Osman Ersoy e a Department of Gastroenterology, Corlu State Hospital, Tekirdag, Turkey b Department of Gastroenterology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey c Department of Biochemistry, Ankara Ataturk Education and Research Hospital, Ankara, Turkey d Department of Biochemistry, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey e Department of Gastroenterology, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey article info Article history: Received 19 January 2017 Accepted 30 November 2017 Available online xxxx Keywords: Mild acute pancreatitis Total antioxidant status Total oxidant status abstract Background and study aims: The mechanisms underlying acute pancreatitis have not been well eluci- dated. Over the last 20 years, there has been increasing awareness regarding the role played by oxidative stress in acute pancreatitis, but it is less well defined in human clinical trials. The aim of this study was to identify the relationship between antioxidants and acute pancreatitis. Patients and methods: We performed a cross-sectional trial on patients with mild acute pancreatitis. The study population consisted of 53 patients with mild acute pancreatitis and 55 healthy controls. Serum paraoxonase, arylesterase activity, total antioxidant status, total oxidant status and thiol levels were measured, and oxidative stress index was calculated. Results: Paraoxonase, arylesterase activity, thiol and total antioxidant status levels were significantly lower in the acute pancreatitis group than in the control group (p = .024, p < .001, p < .001, p = .010, respectively). Oxidative stress index and total oxidant status levels were higher in the acute pancreatitis group than in the control group, but the difference was not statistically significant (p = .135, p = .253, respectively). Conclusions: This study demonstrates that decreased antioxidant levels are associated with mild acute pancreatitis. No association was observed between mild acute pancreatitis and total oxidant status. Ó 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved. Introduction Acute pancreatitis (AP) is one of the most important acute gas- trointestinal disorders throughout much of the world. The inci- dence of AP ranges from 4.6 to 100/100,000 persons in Europe [1]. Gallstones are the most common cause of AP, and mortality ranges from 3% for patients with interstitial (oedematous) pancre- atitis [2] to 15% for patients who develop necrosis [3]. The rate of hospitalisation for AP continues to increase over time [4]. The Atlanta Classification system was developed at a consensus confer- ence in 1992 to establish standard definitions for classification of AP [5], and recently, a completed revision of the Atlanta Classifica- tion and definitions was reported by international consensus [6]. This revised classification of AP identifies two types of the disease: interstitial oedematous pancreatitis and necrotising pancreatitis [6]. Disease severity was classified as mild, moderate and severe in this revision [6]. Mild AP, the most common form, has no organ failure or local and systemic complications and usually resolves in the first week. The major pathophysiologic processes in AP are inflammation, oedema and necrosis of pancreatic tissue [7,8]. AP is initiated by intracellular activation of pancreatic proenzymes and autodigestion of the pancreas. Destruction of the pancreatic parenchyma first induces inflammatory mediators and early organ failure. Concomitantly, anti-inflammatory cytokines and specific cytokine inhibitors are produced [9]. Over the past 150 years, many animal models of pancreatitis have been developed that have allowed researchers to study the pathogenesis and pathophysiol- ogy of AP [10]. Unfortunately, the mechanisms underlying the pathogenesis of AP remain elusive despite significant advances in the last 25 years, and there is no specific therapy because of the obscure pathogenesis [7,11]. It has been shown in many inflamma- tory diseases that oxygen radicals play an important role in the development of inflammation [12]. The similarity of inflammatory tissue damage in inflammatory diseases to that in pancreatitis has led many researchers to study oxidative stress (OS) in AP [12]. Over the last 20 years, there has been increasing awareness regarding the role played by OS in AP [13]. OS occurs when there is an https://doi.org/10.1016/j.ajg.2017.11.008 1687-1979/Ó 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved. ⇑ Corresponding author at: Corlu State Hospital, Bulent Ecevit Boulevard, 59850 Corlu, Tekirdag, Turkey. E-mail addresses: tfksolak@yahoo.com.tr (T. Solakoglu), oerel@ybu.edu.tr (O. Erel). Arab Journal of Gastroenterology xxx (2017) xxx–xxx Contents lists available at ScienceDirect Arab Journal of Gastroenterology journal homepage: www.elsevier.com/locate/ajg Please cite this article in press as: Solakoglu T et al. Association between antioxidants and mild acute pancreatitis. Arab J Gastroenterol (2017), https://doi. org/10.1016/j.ajg.2017.11.008