循环中CD4+CD25+CD127低表达/阴性调节性T细胞增加作为急性胰腺炎的预后生物标志物

Increased Circulating CD4+CD25+CD127low/neg Regulatory T-cells as a Prognostic Biomarker in Acute Pancreatitis.

作者信息

Minkov Georgi A, Yovtchev Yovcho P, Halacheva Krasimira S

机构信息

From the *Department of Surgery, University Hospital "Prof St Kirkovich"; †Department of Molecular Biology, Immunology and Medical genetics, Medical Faculty, Trakia University; and ‡Laboratory of Clinical Immunology, University Hospital "Prof St Kirkovich," Stara Zagora, Bulgaria.

出版信息

Pancreas. 2017 Sep;46(8):1003-1010. doi: 10.1097/MPA.0000000000000894.

DOI:10.1097/MPA.0000000000000894

PMID:28787335

Abstract

OBJECTIVE

Early detection of severe forms with unfavorable outcome is the cornerstone that could provide reduction of morbidity and mortality in acute pancreatitis (AP).

METHODS

The percentage of circulating CD4CD25CD127 regulatory T-cells (Tregs) was determined at admission, on the 48th hour, and on the fifth day in 72 patients with AP. We divided patients in 2 groups-Sev1, which includes 19 patients (26.4%) with moderate AP and 39 patients (54.2%) with mild disease, and Sev2, which includes 14 patients (19.4%) with severe AP. Seven patients (9.7%) developed septic complications. The mortality in our group was 9.7%.

RESULTS

The patients in Sev2 had higher percentage of Tregs at admission and on the fifth day compared with patients in Sev1 (P = 0.007 and P = 0.033, respectively). There was no significant difference in percentage of Tregs at admission, on the 48th hour, and on the fifth day in patients who developed and did not develop infected necrosis (P = 0.50, P = 0.72, and P = 0.92, respectively). Patients with poor outcome had elevated percentage of Tregs on the fifth day (P = 0.045).

CONCLUSIONS

The percentage of circulating Tregs may be implicated in the development of early immune suppression in AP. Elevated percentage of circulating Tregs at admission in AP is an independent prognostic biomarker for severe disease.

摘要

目的

早期发现预后不良的严重形式是降低急性胰腺炎（AP）发病率和死亡率的基石。

方法

对72例AP患者在入院时、第48小时和第5天测定循环CD4CD25CD127调节性T细胞（Tregs）的百分比。我们将患者分为两组——Sev1组，包括19例（26.4%）中度AP患者和39例（54.2%）轻度疾病患者；Sev2组，包括14例（19.4%）重度AP患者。7例（9.7%）患者发生感染性并发症。我们组的死亡率为9.7%。

结果

与Sev1组患者相比，Sev2组患者在入院时和第5天的Tregs百分比更高（分别为P = 0.007和P = 0.033）。发生和未发生感染性坏死的患者在入院时、第48小时和第5天的Tregs百分比无显著差异（分别为P = 0.50、P = 0.72和P = 0.92）。预后不良的患者在第5天的Tregs百分比升高（P = 0.045）。