We present evidence for their mediating role in the relationship between inflammation and pancreatic injury, discover novel biomarker-based patient subgroups with unique clinical characteristics, and identify urinary trypsin-2 as a promising but confounded early signal associated with inflammatory burden in AP, whose relationship to pancreatic injury versus renal clearance requires urgent clarification in studies with renal function data. This evidence concerns the gene PRSS2 and alkaline phosphatase measurement.