Circles denote outliers. 16.05 ng/L, respectively (P 0.01). Respective ideals of caspase-3 were 0.94 0.17 pmol/min 104 cells and 0.34 0.09 pmol/min 104 cells (P 0.05). IL-6 of monocyte supernatants of individuals with sepsis was significantly improved after addition of individuals serum, while that of individuals with acute pancreatitis did not show significant difference. CONCLUSION: The data have shown that monocyte activity is different between acute pancreatitis and sepsis. This trend might be explained like a different pathway to the pro-inflammatory cytokines launch or could be a novel anti-inflammatory response in acute pancreatitis. activity of monocytes upon event of SIRS between individuals with acute pancreatitis and sepsis. MATERIALS AND METHODS Twenty-five individuals were enrolled in a prospective study from January 2003 to June 2003; 13 patients were diagnosed with acute pancreatitis and 12 with sepsis. All were hospitalized in the 4th Division of Internal Medicine of the Medical School of Athens during that period. The study was carried out in accordance to the Helsinki Declaration. Exclusion criteria for the study were the presence of (1) neutropenia ( 500 neutrophils/L), (2) HIV illness, (3) corticosteroids administration for more than one month, defined as more than 1 mg/kg daily of equal prednisone, and (4) protein C administration at least five days before admission. SIRS was defined by the presence of at least two of the followings[4]: (1) pulse rate 90/min, (2) breath rate 20/min or PCO2 32 mmHg, and (3) leukocytosis [white blood cells (WBCs) 12?000/L] or leucopenia (WBCs 4000/L) or more than 10% bands. Inclusion criteria were the following for acute pancreatitis[5]: (1) SIRS, (2) initiation of a typical epigastric pain radiating to the back over the last 12 h before admission; (3) serum amylase at least three times above normal ideals, (4) urine amylase at least three times above (3β,20E)-24-Norchola-5,20(22)-diene-3,23-diol normal ideals, (5) findings of acute edematous pancreatitis on ultrasound or on computed tomography, and (6) the absence of any main liver disease. Inclusion criteria for sepsis were the following in accordance to ASCP/SCCM 1997 classification[4]: (1) clinically proven illness with fever as its 1st manifestation over the last 12 h before admission, and (2) SIRS. Main infections for sepsis were acute pyelonephritis, lower respiratory tract illness (LRTI) and acute cholangitis. The analysis of acute pyelonephritis was made on the basis of the following criteria[6,7]: (1) a case history compatible with acute pyelonephritis comprising at (3β,20E)-24-Norchola-5,20(22)-diene-3,23-diol least two spikes of fever above 38C and presence NFBD1 of lumbar tenderness on exam, (2) pyuria defined as presence of more than 10 polymorphs per high power field under a light microscope, and (3) positive urinary tradition with the colony count exceeding 104 cfu/mL for a single Gram-negative bacterial varieties. Analysis of LRTI was founded in any individual presenting with the following indications: (1) core temp 38C, and (2) fresh or persistent consolidation on lung X-ray[8]. Analysis of acute cholangitis was based on the following criteria: (1) core temp 38C, (2) acute pain of upper right quadrant of belly elicited on palpation, and (3) ultrasound findings compatible with cholangitis[9]. Upon admission, a total of 20 mL of blood were collected after puncture of one forearm vein. Ten milliliters of blood were collected inside a sterile heparinized syringe and the remaining inside a sterile tube. Blood was centrifuged and the supernatant was kept at -70C until assayed. For the isolation of blood monocytes[10], the collected heparinized venous blood was layered over Ficoll Hypaque (Biochrom, Berlin, Germany) and centrifuged. Isolated mononuclear cells were washed three times with PBS (pH 7.2) (Merck, Darmsadt, Germany) and incubated with RPMI 1640 enriched with 10% FBS and 2 mmol/L of glutamine in the presence of 100 U/mL of penicillin G and 0.1 g/L of streptomycin (Sigma Co, St. Louis, USA) in flasks of 25 cm3. After one hour of incubation at 37C in 5% CO2, non-adherent cells were eliminated; adherent monocytes were thoroughly washed with Hanks remedy (Biochrom). Monocytes were then harvested with the (3β,20E)-24-Norchola-5,20(22)-diene-3,23-diol application of a 0.25% trypsin/0.02% EDTA remedy (Biochrom) and counted inside a Neubauer plate. Their purity (3β,20E)-24-Norchola-5,20(22)-diene-3,23-diol was more than 95% as identified after staining with the anti-CD14 monoclonal antibody in the fluorocolor FITC (emission 520 nm, Immunotech, Marseille, France).