TABLE 2.

Patient studies of MIF in acute pancreatitis.

Patient population	Severity definition	Blood sampling time from pain onset	Key findings	Refs
Healthy controls (n = 12). Mild AP (n = 28). Severe AP (n = 18)	OAC	<72 h	Serum MIF levels were significantly higher in severe AP (median 45, range [20–112] ng/ml) compared with mild AP (26 [1–70] ng/ml) or healthy controls (18 [11–34] ng/ml) (both p < 0.01)	Sakai et al. (2003)
Healthy controls (n = 10). Mild AP (n = 45). Severe AP (n = 19)	OAC	24 h	1) serum MIF levels were raised in severe AP (median 58, range [13–181] ng/ml), multiple organ failure, or pancreatic necrosis compared with mild AP (20 [5–80] ng/ml) or healthy controls (18 [12–57] ng/ml) (all p < 0.01); 2) serum MIF levels significantly correlated with serum 24-h CRP (r = 0.36, p = 0.02), peak CRP (r = 0.36, p = 0.003), and 48-h APACHE II score (r = 0.29, p = 0.03). 3) 24-h serum MIF was superior to sCD14 and sCD163 in predicting severity (AUC, 0.84), multiple organ failure (AUC, 0.80), and pancreatic necrosis (AUC, 0.86) (all p < 0.001)	Rahman et al. (2007)
Healthy controls (n = 197). Mild AP (n = 116). Severe (n = 48)	OAC	NA	1) AP vs. controls for distribution of MIF-173 gene genotype (p = 0.046); 2) AP vs. controls for distribution of MIF-794 microsatellite genotypes (p = 0.367) and alleles (p = 0.342)	Makhija et al. (2007)
Healthy controls (n = 18). Mild AP (n = 60). Severe (n = 48)	APACHE II > 7, imrie-glasgow > 2, or MODS >2	<72 h	1) peripheral leukocyte mRNA levels of MIF in AP patients were 6.5-fold higher than healthy controls; serum MIF levels in AP patients were 10.3-fold higher than controls; 2) prognostic utility of serum MIF: Severity: Cutoff (>1,186 pg/ml), AUC (0.71), Se = 0.47, Sp = 0.93, p < 0.01. Necrosis: Cutoff (>2,707 pg/ml), AUC (0.55), Se = 0.23, Sp = 0.95, p = 0.47. Death: Cutoff (>633 pg/ml), AUC (0.84), Se = 1.00, Sp = 0.61, p < 0.01	Dambrauskas et al. (2010)
Healthy controls (n = 10). Mild AP (n = 20). Moderately severe AP (n = 30). Severe AP (n = 20)	RAC	<72 h	1) plasma MIF levels were elevated in AP patients and were associated with disease severity (control: IQR 296, [57–557] pg/ml; mild: 438 [143–1,453] pg/ml; moderately severe: 717 [201–2,631] pg/ml; severe: 2,984 [74–44,786] pg/ml); 2) prognostic utility of plasma MIF in discriminating severe AP from non-severe AP and healthy controls: Cutoff (>1,520 pg/ml), AUC (0.90), Se = 0.75, Sp = 0.98, p < 0.001	Deng et al. (2017)
Healthy controls (n = 10). Mild AP (n = 52). Moderate severe AP (n = 65). Severe AP (n = 26)	RAC	<48 h	1) plasma MIF levels were elevated in non-severe AP (1.68 ± 2.04 ng/ml) and severe AP (6.04 ± 4.05 ng/ml) than healthy controls (0.51 ± 0.23 ng/ml); 2) prognostic utility of plasma MIF in discriminating severe AP from non-severe AP and healthy controls: Cut-off (> 2.30 ng/ml), AUC (0.950), Se = 0.962, Sp = 0.803	Shen et al. (2021)

MIF, macrophage migration inhibitory factor; AP, acute pancreatitis; OAC, original Atlanta classification; CRP, C-reactive protein; APACHE II, Acute Physiology and Chronic Health Evaluation II; AUC, area under the receiver operating characteristic curve; RAC, revised Atlanta classification; Se, sensitivity; Sp, specificity.