Dabrowski Andrzej, Osada Joanna, Dabrowska Milena I, Wereszczynska-Siemiatkowska Urszula
Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
Pancreatology. 2008;8(2):126-34. doi: 10.1159/000123605. Epub 2008 Apr 1.
Alteration of the immune system is one of the major mechanisms responsible for complications in severe acute pancreatitis (AP). The aim of our study was to provide a complex evaluation of peripheral blood monocyte subsets, natural killer cells (NK cells) and cytotoxic T lymphocytes in patients with different severity forms of AP.
20 patients with mild AP and 15 with severe AP (S-AP) were included in our study. Peripheral blood mononuclear cells were studied on days 1-3, 5, 10 and 30, by means of flow cytometry.
In peripheral blood of patients with pancreatitis, we found a marked increase in total monocyte count. In S-AP, circulating monocytes were significantly activated, which was presumed from increased expression of HLA-DR, CD54, CD69 and CD25. Concurrent increased expression of CD95 (FasR) may indicate enhanced susceptibility of these cells to apoptosis. In patients with S-AP, a dramatic depletion of circulating NK cells (CD16/56 and CD3- CD8+) was found along with a reduction of circulating CD3+ CD8+ lymphocytes (cytotoxic T lymphocytes).
Our findings suggest profound disturbances of innate cellular immunity in patients with S-AP.
免疫系统改变是重症急性胰腺炎（AP）并发症的主要机制之一。我们研究的目的是对不同严重程度AP患者的外周血单核细胞亚群、自然杀伤细胞（NK细胞）和细胞毒性T淋巴细胞进行综合评估。
我们的研究纳入了20例轻症AP患者和15例重症AP（S-AP）患者。在第1 - 3天、第5天、第10天和第30天，采用流式细胞术对外周血单个核细胞进行研究。
在胰腺炎患者的外周血中，我们发现单核细胞总数显著增加。在S-AP中，循环单核细胞明显被激活，这可从HLA-DR、CD54、CD69和CD25表达增加推测得出。同时，CD95（FasR）表达增加可能表明这些细胞对凋亡的易感性增强。在S-AP患者中，发现循环NK细胞（CD16/56和CD3 - CD8+）显著减少，同时循环CD3+ CD8+淋巴细胞（细胞毒性T淋巴细胞）也减少。
我们的研究结果表明S-AP患者存在先天性细胞免疫的严重紊乱。
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