Acute pancreatitis (AP) is an inflammatory disorder of the pancreas and is among the most common gastrointestinal disorders resulting in hospitalization worldwide. Diagnosis of AP remains challenging for two reasons: 1) current biomarkers (serum lipase and amylase) have poor specificity to pancreatic disease, and 2) the temporal nature of AP complicates point-of-care testing that requires blood-based biomarkers. In this work, we apply urine proteomics to study a discovery cohort containing 130 pediatric patients under 21 years old including a mixture of AP subjects, chronic pancreatitis (CP) subjects, extremity fracture pain controls, and healthy controls. We identified five robustly differential proteins that statistically segregated AP from other groups, including the previously known biomarker, pancreatic alpha-amylase (AMY2A). As part of this talk, we will also discuss modes of proteomics data acquisition and analysis that facilitate biomarker discovery and validation in complex and diverse cohorts. This work underlines the promising role of urinary markers in the diagnosis of AP and the potential f or non-invasive testing that can provide timely and accurate diagnosis.

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