CASP3 and alkaline phosphatase measurement: Clues to the mechanisms of how AP may result in infection come from previous studies reporting lymphocyte apoptosis during AP14 and severe AP associated with a reduction in T-lymphocytes.14,15 Separately, lymphocyte apoptosis16 and active caspase-3 staining in the T-cell–rich splenic white pulp have been reported previously in clinical autopsies during non-AP sepsis.17 However, the mechanisms of immune cell injury, and whether they can convert a sterile disease to an infected one, are unknown.