Harnessing early enzymatic biomarkers and cytokines for risk prediction in post-endoscopic retrograde cholangiopancreatography pancreatitis

Sep 28, 2026

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This editorial critically evaluates evidence on using 4-hour serum amylase and lipase as early blood markers to predict post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis. While these enzymes support early diagnosis, they do not reliably specify disease etiology and offer limited mechanistic insight into progression. The discussion highlights increased cytokines—especially IL-6, TNF-α, and IL-8—as candidates for predicting severity. Integrating such biomarkers with enzymatic and prognostic scoring systems may improve accuracy and enable earlier, more effective patient management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

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Editorial

Abstract

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Early enzymatic biomarkers and their limitations in the diagnosis of post-ERCP pancreatitis

| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2025 December 28; 31(48): 114786 DOI: 10.3748/wjg.v31.i48.114786 ISSN 1007-9327 (print) ISSN 2219-2840 (online) EDITORIAL Harnessing early enzymatic biomarkers and cytokines for risk prediction in post-endoscopic retrograde cholangiopancreatography pancreatitis Abdellatif Bouayad Specialty type: Gastroenterology and hepatology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade B Novelty: Grade B, Grade C Creativity or Innovation: Grade B, Grade C Scientific Significance: Grade B, Grade B P-Reviewer: Saeed S, PhD, China; Yang F, MD, Professor, China Received: September 27, 2025 Revised: October 28, 2025 Accepted: November 12, 2025 Published online: December 28, 2025 Processing time: 90 Days and 9.5 Hours Abdellatif Bouayad, Laboratory of Immunology, Mohammed First University, Faculty of Medicine and Pharmacy Oujda, Oujda-Angad 4867, Oriental, Morocco Corresponding author: Abdellatif Bouayad, MD, Associate Professor, Laboratory of Immunology, Mohammed First University, Faculty of Medicine and Pharmacy Oujda, 4867 Oujda l’Université, Oujda-Angad 4867, Oriental, [Morocco.](Morocco. a.bouayad@ump.ac.ma)[ a.bouayad@ump.ac.ma](Morocco. a.bouayad@ump.ac.ma) Abstract This editorial critically analyses the recent article by Jung et al, which investigates the utility of 4-hour serum amylase and lipase as early blood markers for postendoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis prediction. Although these enzymes are valuable for the early diagnosis of postERCP pancreatitis, they lack specificity for disease etiology and provide limited insight into the molecular mechanisms underlying disease progression. Several cytokines, notably interleukin (IL)-6, tumor necrosis factor-alpha, and IL-8, are increased in post-ERCP pancreatitis and may serve as potential predictors for disease severity. The incorporation of these biomarkers in early enzymatic biomarkers and established prognostic scoring systems could further enhance their accuracy and allow for earlier, more effective management of patients with postERCP pancreatitis. Key Words: Cytokines; Enzymatic biomarkers; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Early diagnosis; Prognosis ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. Core Tip: Although high serum 4-hour amylase and lipase levels enable early diagnosis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, they have limited prognostic value and lack etiological specificity. Interleukin (IL)-6 has emerged as an early inflammatory biomarker for predicting post-ERCP pancreatitis severity. However, detection and quantification of this cytokine remain costly. Validation of rapid, cost-effective, and point-of-care IL-6 immunoassays is essential for their integration into routine clinical practice for post-ERCP pancreatitis risk prediction. WJG [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 28, 2025 Volume 31 Issue 48 Bouayad A. Biomarkers and cytokines in post-ERCP pancreatitis Citation: Bouayad A. Harnessing early enzymatic biomarkers and cytokines for risk prediction in post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastroenterol 2025; 31(48): 114786 URL: [https://www.wjgnet.com/1007-9327/full/v31/i48/114786.htm](https://www.wjgnet.com/1007-9327/full/v31/i48/114786.htm) DOI: [https://dx.doi.org/10.3748/wjg.v31.i48.114786](https://dx.doi.org/10.3748/wjg.v31.i48.114786) INTRODUCTION Acute post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is an inflammatory condition of the pancreas characterized

FAQs

Why are 4-hour serum amylase and lipase considered for early prediction after ERCP pancreatitis?

Because they can enable early diagnosis and reflect early pancreatic injury mechanisms shortly after ERCP, helping identify patients soon after the procedure.

What limitations do amylase and lipase have for risk prediction?

They lack specificity for disease etiology and provide limited insight into the molecular mechanisms driving disease severity and progression.

Which cytokines are highlighted as potential predictors of post-ERCP pancreatitis severity?

Interleukin-6 (IL-6) is emphasized, along with tumor necrosis factor-alpha (TNF-α) and IL-8, which are increased in post-ERCP pancreatitis and may predict severity.

Sep 28, 2026

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