Will the next generation of surgeons be ordering a gene expression profile with the admission laboratory tests of the patient with pancreatitis? This article by Bluth et al makes this scenario a distinct possibility.
Gene expression profiling using microarrays has emerged as a powerful tool to profile the expression of thousands of genes within the human genome as illustrated by the recent Food and Drug Administration approval of the MammaPrint (Agendia, Louwesweg, Amsterdam) assay for breast cancer prognosis.1 In expression profiling, RNA is isolated from tissues and hybridized to complementary probes for specific genes that are fixed in a grid in small microscopic spots, typically on a glass slide, and the intensity of the hybridization probes correlates with expression compared with controls. This allows a comprehensive look at the expression profile for any disease state or allows comparison of different subsets to develop predictive signatures. Previous investigators have used expression profiling to characterize acute pancreatitis using fresh tissues.2,3 In their article, Bluth et al now describe a noninvasive modality, using an easily accessible source, PBMCs, to perform expression profiling for the characterization of severe pancreatitis in a rat model. The investigators are to be applauded for doing this successfully.