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Inflammation Research

Erschienen in:

01.07.2012 | Original Research Paper

Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis

verfasst von: YinFeng Shen, Nai-Qiang Cui

Erschienen in: Inflammation Research | Ausgabe 7/2012

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Abstract

Objectives

To observe immune system changes in patients with secondary infection from severe acute pancreatitis (SAP).

Methods

Seventy-nine patients were recruited. The percentages of CD4+, CD8+, natural killer (NK), HLA-DR+ cells and B lymphocytes, and the CD4+/CD8+ ratio, were determined. In addition, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-4 (IL-4) serum levels were determined on days 1, 7, 14, and 28.

Results

Fifteen patients had a secondary infection. The immune response of the infected group was quite different from the non-infected group, with a higher percentage of CD4+ and HLA-DR+ cells on days 1, 7, 14 and 28, a higher percentage of CD8+ and NK cells on days 14 and 28, a reduced CD4+/CD8+ ratio, and a reduction in B lymphocytes. The cytokine levels in the infected group were different from the non-infected group, with a rise in TNF-α and IL-6 through the first 2 weeks, but dropping at 1 month. IL-10 and IL-4 increased initially, but then dropped over the next 3 weeks.

Conclusions

An early excessive immune response followed by a subsequent immune deficiency is closely related to secondary SAP infection.

Beger HG, Rau B, Isenmann R. Natural history of necrotizing pancreatitis. Pancreatology. 2003;3:93–101.PubMedCrossRef

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

Bumbasirevic V, Radenkovic D, Jankovic Z, et al. Severe acute pancreatitis: overall and early versus late mortality in intensive care units. Pancreas. 2009;38:122–5.PubMedCrossRef

Eckerwall GE, Axelsson JB, Andersson RG. Early nasogastric feeding in predicted severe acute pancreatitis: a clinical, randomized study. Ann Surg. 2006;244:959–65.PubMedCrossRef

Mizuguchi T, Mukaiya M, Imaizumi H, et al. Successful management of severe acute pancreatitis with multiple organ failure. Pancreas. 2004;28:211–3.PubMedCrossRef

Lytras D, Manes K, Triantopoulou C, et al. Persistent early organ failure: defining the high-risk group of patients with severe acute pancreatitis? Pancreas. 2008;36:249–54.PubMedCrossRef

Zhang J, Yuan C, Hua G, et al. Early gut barrier dysfunction in patients with severe acute pancreatitis: attenuated by continuous blood purification treatment. Int J Artif Organs. 2010;33:706–15.PubMed

Zhang X, Chen L, Luo L, et al. Study of the protective effects of dexamethasone on ileum mucosa injury in rats with severe acute pancreatitis. Pancreas. 2008;37:e74–82.PubMedCrossRef

Luan ZG, Zhang H, Ma XC, et al. Role of high-mobility group box 1 protein in the pathogenesis of intestinal barrier injury in rats with severe acute pancreatitis. Pancreas. 2010;39:216–23.PubMedCrossRef

10.

Takeyama Y. Significance of apoptotic cell death in systemic complications with severe acute pancreatitis. J Gastroenterol. 2005;40:1–10.PubMedCrossRef

11.

Liu Z, Shen Y, Cui N, et al. Clinical observation of immunity for severe acute pancreatitis. Inflammation. 2011;34:426–31.PubMedCrossRef

12.

Shen Y, Cui N, Miao B, et al. Immune dysregulation in patients with severe acute pancreatitis. Inflammation. 2010;34:36–42.CrossRef

13.

Bradley EL 3rd. A clinically based classification system for acute pancreatitis: summary of the International Symposium on Acute Pancreatitis, Atlanta, GA, September 11 through 13, 1992. Arch Surg. 1993;128:586–90.PubMedCrossRef

14.

Gravante G, Garcea G, Ong SL, et al. Prediction of mortality in acute pancreatitis: a systematic review of the published evidence. Pancreatology. 2009;9:601–14.PubMedCrossRef

15.

Beger HG, Rau B, Mayer J, Pralle U. Natural course of acute pancreatitis. World J Surg. 1997;21:130–5.PubMedCrossRef

16.

Halonen KI, Pettilä V, Leppäniemi AK, et al. Multiple organ dysfunction associated with severe acute pancreatitis. Crit Care Med. 2002;30:1274–9.PubMedCrossRef

17.

Wu XM, Ji KQ, Wang HY, et al. Total enteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis. Pancreas. 2010;39:248–51.PubMedCrossRef

18.

Zhang XP, Chen HQ, Liu F, et al. Advances in researches on the immune dysregulation and therapy of severe acute pancreatitis. J Zhejiang Univ Sci B. 2009;10:493–8.PubMedCrossRef

19.

Beger HG, Rau BM. Severe acute pancreatitis: clinical course and management. World J Gastroenterol. 2007;13:5043–51.PubMed

20.

Shi CB, Zhao X, Lagergren A, et al. Immune status and inflammatory response differ locally and systemically in severe acute pancreatitis. Scand J Gastroenterol. 2006;41:472–80.PubMedCrossRef

21.

Bone R. Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: what we do and what we do not know about cytokine regulation. Crit Care Med. 1996;24:163–72.PubMedCrossRef

22.

Liu H, Li W, Wang X, et al. Early gut mucosal dysfunction in patients with acute pancreatitis. Pancreas. 2008;36:192–6.PubMedCrossRef

23.

Liu HB, Cui NQ, Wang Q, et al. Sphingosine-1-phosphate and its analogue FTY720 diminish acute pulmonary injury in rats with acute necrotizing pancreatitis. Pancreas. 2008;36:e10–5.PubMedCrossRef

24.

Lu F, Huang H, Wang F, et al. Intestinal capillary endothelial barrier changes in severe acute pancreatitis. Hepatogastroenterology. 2011;58:1009–17.PubMedCrossRef

25.

Cicalese L, Sahai A, Sileri P, et al. Acute pancreatitis and bacterial translocation. Dig Dis Sci. 2001;46:1127–32.PubMedCrossRef

26.

Holmes CL, Russell JA, Walley KR. Genetic polymorphisms in sepsis and septic shock: role in prognosis and potential for therapy. Chest. 2003;124:1103–15.PubMedCrossRef

27.

de-Madaria E, Martínez J, Sempere L, et al. Cytokine genotypes in acute pancreatitis: association with etiology, severity, and cytokine levels in blood. Pancreas. 2008;37:295–301.

28.

Curley PJ. Endotoxin, cellular immune dysfunction and acute pancreatitis. Ann R Coll Surg Engl. 1996;78:531–5.PubMed

29.

Uehara S, Gothoh K, Handa H, et al. Immune function in patients with acute pancreatitis. J Gastroenterol Hepatol. 2003;18:363–70.PubMedCrossRef

30.

Curley PJ, McMahon MJ, Lancaster F, et al. Reduction in circulating levels of CD4-positive lymphocytes in acute pancreatitis: relationship to endotoxin, interleukin-6 and disease severity. Br J Surg. 1993;80:1312–5.PubMedCrossRef

31.

Yao W, Zhu Q, Yuan Y, et al. Thymosin alpha 1 improves severe acute pancreatitis in rats via regulation of peripheral T cell number and cytokine serum level. J Gastroenterol Hepatol. 2007;22:1866–71.PubMedCrossRef

32.

Abbas AK, Murphy KM, Sher A. Functional diversity of helper T lymphocytes. Nature. 1996;383:787–93.PubMedCrossRef

33.

Kylänpää ML, Repo H, Puolakkainen PA. Inflammation and immunosuppression in severe acute pancreatitis. World J Gastroenterol. 2010;16:2867–72.PubMedCrossRef

34.

Titel: Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis
verfasst von: YinFeng Shen
Nai-Qiang Cui
Publikationsdatum: 01.07.2012
Verlag: SP Birkhäuser Verlag Basel
Erschienen in: Inflammation Research / Ausgabe 7/2012
Print ISSN: 1023-3830
Elektronische ISSN: 1420-908X
DOI: https://doi.org/10.1007/s00011-012-0467-1

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Abstract

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