IL18 Works Like a Two-Side Coin in Acute Pancreatitis

Purpose: Acute pancreatitis is a common disease with limited supportive treatments. Finding effective biomarkers is of great significance for early diagnosis and therapy, as well as to achieve better prognosis. Materials and Methods: The core genes of AP were identified through bioinformatics and machine learning. The expression, clinical features, biological function and immunological effects of the characteristic gene were also evaluated. AP murine models were constructed to verify the results in vivo. Finally, Mendelian randomization studies were performed to determine the causal relationship between IL-18 and AP through genome-wide association studies. Results: A total of 100 core genes were obtained, and IL18 was identified as the characteristic gene for AP. The expression of IL18 was increased in AP ( p < 0.001) with an AUC value of 0.917. And some immune responses were inhibited when IL18 is highly expressed. In addition, the OR for IL18 and AP was 0.908 (95% CI = 0.843– 0.978, p =0.011) via inverse variance weighting (IVW). Conclusion: Elevated IL18 can be used to predict the clinical prognosis and immune responses in AP. Meanwhile, MR suggests that an increase in IL18 indicates a low risk of AP, implying that the course of AP often presents a self-limiting feature in clinic.