Department of Hepatobiliary Surgery, Third People's Hospital of Wuxi Affiliated to Medical School of Nantong University, Wuxi 214041, Jiangsu, P R China.
Front Biosci (Landmark Ed). 2013 Jun 1;18(3):892-900. doi: 10.2741/4150.
Few data are available on the relationship between immune response and the infection caused by gut mucosal barrier dysfunction in patients with severe acute pancreatitis (SAP). The aim of this study was to investigate the immune response to gut mucosal barrier dysfunction in patients with early SAP. The results showed that the levels of endotoxin, the lactulose/mannitol (L/M) ratio, the D(-)-lactate concentration, the proportion of HLA-DR-positive monocytes, and the expression levels of TNF-α, IL-6 and IL-10 all decreased from a high level while the frequency of Tregs increased during the first 14 days. The Th1/Th2 ratio was decreased, with a decreased Th1 and an increased Th2 profile, in the beginning, but it was subsequently increased, with an increased Th1 profile. The data from this study showed that immunosuppression, the shift of the Th1/Th2 balance toward a Th2 response, increased Tregs, and related inflammatory cytokines are involved in the complex process of inflammation and infection caused by gut mucosal barrier dysfunction in patients with early SAP.
关于免疫反应与重症急性胰腺炎（SAP）患者肠道黏膜屏障功能障碍所致感染之间的关系，目前仅有少量数据。本研究旨在探讨早期 SAP 患者肠道黏膜屏障功能障碍的免疫反应。结果表明，在发病的最初 14 天内，内毒素、乳果糖/甘露醇（L/M）比值、D（-）-乳酸浓度、HLA-DR 阳性单核细胞比例以及 TNF-α、IL-6 和 IL-10 的表达水平均从高水平下降，而 Tregs 的频率增加。Th1/Th2 比值最初下降，表现为 Th1 减少和 Th2 增加，但随后增加，表现为 Th1 增加。本研究的数据表明，免疫抑制、Th1/Th2 平衡向 Th2 反应的转移、Tregs 的增加以及相关炎症细胞因子均参与了早期 SAP 患者肠道黏膜屏障功能障碍所致炎症和感染的复杂过程。
