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Inflammation

Erschienen in:

01.10.2011

Clinical Observation of Immunity for Severe Acute Pancreatitis

verfasst von: ZhiMin Liu, YinFeng Shen, NaiQiang Cui, Jing Yang

Erschienen in: Inflammation | Ausgabe 5/2011

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Abstract

The aim of our study was to observe the dynamic changes of immunity for patients with severe acute pancreatitis (SAP) and intervention by traditional Chinese medicine. Twenty-three patients who met the inclusion criteria were randomized to combined treatment of traditional Chinese medicine and Western medicine (TCM) or conventional western medicine treatment (WM) groups. The clinical data for all patients were collected. Peripheral venous blood samples were obtained from patients on days 1, 7, 14, and 28 after admission. Biochemical data including the percentage of CD4+/CD8+/natural killer (NK) cells/B lymphocytes/HLA-DR and CD4+/CD8+ ratio in serum were determined by flow cytometer. Patients’ characteristics and immunity at admission were similar between the two groups. The secondary infection was different. The levels of T-lymphocyte subsets in the TCM group were quite different from the WM group, with much more the percentage of CD4+ and the CD4+/CD8+ ratio on days 7, 14, and 28 and much less the percentage of CD8+ on days 14 and 28. On days 14 and 28, the levels of NK cells and B lymphocytes were significantly higher in the TCM group compared with the controls. Compared with the TCM group, the levels of HLA-DR were significantly decreased in the WM group on days 7, 14, and 28. The immune dysregulation exists in the development and progression of SAP. The combined treatment of traditional Chinese medicine and western medicine can upregulate the patient’s immune and maintain the immune balance.

Bumbasirevic, V., D. Radenkovic, Z. Jankovic, et al. 2009. Severe acute pancreatitis: Overall and early versus late mortality in intensive care units. Pancreas 38: 122–125.PubMedCrossRef

Appelros, S., S. Lindgren, and A. Borgström. 2001. Short and long term outcome of severe acute pancreatitis. The European Journal of Surgery 167: 281–286.PubMedCrossRef

Tang, W.F., Y.G. Wang, L. Zhu, et al. 2007. Effect of somatostatin on immune inflammatory response in patients with severe acute pancreatitis. Journal of Digestive Diseases 8: 96–102.PubMedCrossRef

Zhang, X.P., H.Q. Chen, F. Liu, et al. 2009. Advances in researches on the immune dysregulation and therapy of severe acute pancreatitis. Journal of Zhejiang University. Science B 10: 493–498.PubMedCrossRef

de Beaux, A.C., J.A. Ross, J.P. Maingay, et al. 1996. Proinflammatory cytokine release by peripheral blood mononuclear cells from patients with acute pancreatitis. The British Journal of Surgery 83: 1071–1075.PubMedCrossRef

Widdison, A.L., and S. Cunningham. 1996. Immune function early in acute pancreatitis. The British Journal of Surgery 83: 633–636.PubMedCrossRef

Feili, G. 2004. Medical immunology. Beijing: Scientific.

Takeyama, Y. 2005. Significance of apoptotic cell death in systemic complications with severe acute pancreatitis. Journal of Gastroenterology 40: 1–10.PubMedCrossRef

Tellado, J.M. 2007. Prevention of infection following severe acute pancreatitis. Current Opinion in Critical Care 13: 416–420.PubMedCrossRef

10.

Takeyama, Y., K. Takas, T. Ueda, et al. 2000. Peripheral lymphocyte reduction in severe acute pancreatitis is caused by apoptotic cell death. Journal of Gastrointestinal Surgery 4: 379–387.PubMedCrossRef

11.

Bradley 3rd, E.L. 1993. A clinically based classification system for acute pancreatitis: summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Archives of Surgery 128: 586–590.PubMed

12.

UK Working Party on Acute Pancreatitis. 2005. UK guidelines for the management of acute pancreatitis. Gut 54: iii1–iii9.CrossRef

13.

Gravante, G., G. Garcea, S.L. Ong, et al. 2009. Prediction of mortality in acute pancreatitis: A systematic review of the published evidence. Pancreatology 9: 601–614.PubMedCrossRef

14.

Balthazar, E.J. 2002. Acute pancreatitis: Assessment of severity with clinical and CT evaluation. Radiology 223: 603–613.PubMedCrossRef

15.

Eckerwall, G.E., J.B. Axelsson, and R.G. Andersson. 2006. Early nasogastric feeding in predicted severe acute pancreatitis: A clinical, randomized study. Annals of Surgery 244: 959–965.PubMedCrossRef

16.

Mofidi, R., M.D. Duff, S.J. Wigmore, et al. 2006. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. The British Journal of Surgery 93: 738–344.PubMedCrossRef

17.

Norman, J. 1998. The role of cytokines in the pathogenesis of acute pancreatitis. American Journal of Surgery 175: 76–83.PubMedCrossRef

18.

Yubero, S., L. Ramudo, M.A. Manso, et al. 2009. Targeting peripheral immune response reduces the severity of necrotizing acute pancreatitis. Critical Care Medicine 37: 240–245.PubMedCrossRef

19.

Beger, H.G., and B.M. Rau. 2007. Severe acute pancreatitis: clinical course and management. World Journal of Gastroenterology 13: 5043–5051.PubMed

20.

Shi, C.B., X. Zhao, A. Lagergren, et al. 2006. Immune status and inflammatory response differ locally and systemically in severe acute pancreatitis. Scandinavian Journal of Gastroenterology 41: 472–480.PubMedCrossRef

21.

Bone, R. 1996. Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: What we do and what we do not know about cytokine regulation. Critical Care Medicine 24: 163–172.PubMedCrossRef

22.

Rahman, S.H., A.M. James, B. Ammori, et al. 2002. Ischaemia-reperfusion injury, gut macromolecular permeability and severe acute pancreatitis. The British Journal of Surgery 89: 34–34.CrossRef

23.

Ammori, B.J., P.C. Leeder, R.F. King, et al. 1999. Early increase in intestinal permeability in patients with severe acute pancreatitis: Correlation with endotoxemia, organ failure, and mortality. Journal of Gastrointestinal Surgery 3: 252–262.PubMedCrossRef

24.

Rahman, S.H., G. Salter, J.H. Holmfield, et al. 2004. Soluble CD14 receptor expression and monocyte heterogeneity but not the C-260T CD14 genotype are associated with severe acute pancreatitis. Critical Care Medicine 32: 2457–2463.PubMedCrossRef

25.

Monneret, G., F. Venet, A. Pachot, et al. 2008. Monitoring immune dysfunctions in the septic patient: A new skin for the old ceremony. Molecular Medicine 14: 64–78.PubMedCrossRef

26.

Tsui, N.C., E. Zhao, Z. Li, et al. 2009. Microbiological findings in secondary infection of severe acute pancreatitis: A retrospective clinical study. Pancreas 38: 499–502.PubMedCrossRef

27.

Uehara, S., K. Gothoh, H. Handa, et al. 2003. Immune function in patients with acute pancreatitis. Journal of Gastroenterology and Hepatology 18: 363–370.PubMedCrossRef

28.

Marshall, J.C., N.V. Christou, and J.L. Meakins. 1993. The gastrointestinal tract: The ‘undrained abscess’ of multiple organ failure. Annals of Surgery 218: 111–119.PubMedCrossRef

29.

Liu, H.B., N.Q. Cui, Q. Wang, D.H. Li, and X.P. Xue. 2008. Sphingosine-1-phosphate and its analogue FTY720 diminish acute pulmonary injury in rats with acute necrotizing pancreatitis. Pancreas 36: e10–e15.PubMedCrossRef

30.

Liu, H., W. Li, X. Wang, J. Li, and W. Yu. 2008. Early gut mucosal dysfunction in patients with acute pancreatitis. Pancreas 36: 192–196.PubMedCrossRef

31.

Xia, Q., J.M. Jiang, X. Gong, et al. 2000. Experimental study of Tong Xia purgative method in ameliorating lung injury in acute necrotizing pancreatitis. World Journal of Gastroenterology 6: 115–118.PubMed

32.

Gong, H.L., W.F. Tang, Q. Yu, et al. 2009. Effect of severe acute pancreatitis on pharmacokinetics of Da-Cheng-Qi Decoction components. World Journal of Gastroenterology 15: 5992–5999.PubMedCrossRef

33.

Qiu, Y., Y.Y. Li, S.G. Li, et al. 2004. Effect of Qingyitang on activity of intracellular Ca₂₊-Mg₂₊-ATPase in rats with acute pancreatitis. World Journal of Gastroenterology 10: 100–104.PubMed

34.

Ammori, B.J. 2003. Role of the gut in the course of severe acute pancreatitis. Pancreas 26: 122–129.PubMedCrossRef

35.

Curley, P.J., M.J. McMahon, F. Lancaster, et al. 1993. Reduction in circulating levels of CD4-positive lymphocytes in acute pancreatitis: Relationship to endotoxin, interleukin-6 and disease severity. The British Journal of Surgery 80: 1312–1315.PubMedCrossRef

36.

Yao, W., Q. Zhu, Y. Yuan, et al. 2007. Thymosin alpha 1 improves severe acute pancreatitis in rats via regulation of peripheral T cell number and cytokine serum level. Journal of Gastroenterology and Hepatology 22: 1866–1871.PubMedCrossRef

37.

Tonegawa, S. 1988. Antibody and T-cell receptors. JAMA 259: 1845–1847.PubMedCrossRef

38.

Ho, Y.P., I.S. Sheen, C.T. Chiu, et al. 2006. A strong association between down-regulation of HLA-DR expression and the late mortality in patients with severe acute pancreatitis. The American Journal of Gastroenterology 101: 1117–1124.PubMedCrossRef

39.

Kylanpaa, M.L., P. Mentula, E. Kemppainen, et al. 2005. Monocyte anergy is present in patients with severe acute pancreatitis and is significantly alleviated by granulocyte-macrophage colony-stimulating factor and interferon-gamma in vitro. Pancreas 31: 23–27.PubMedCrossRef

40.

DiMagno, M.J., and E.P. DiMagno. 2007. New advances in acute pancreatitis. Current Opinion in Gastroenterology 23: 494–501.PubMed

41.

Frossard, J.L., M.L. Steer, and C.M. Pastor. 2008. Acute pancreatitis. Lancet 371: 143–152.PubMedCrossRef

Titel: Clinical Observation of Immunity for Severe Acute Pancreatitis
verfasst von: ZhiMin Liu
YinFeng Shen
NaiQiang Cui
Jing Yang
Publikationsdatum: 01.10.2011
Verlag: Springer US
Erschienen in: Inflammation / Ausgabe 5/2011
Print ISSN: 0360-3997
Elektronische ISSN: 1573-2576
DOI: https://doi.org/10.1007/s10753-010-9249-5

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