Unidad de Investigación Médica en Inmunoquímica, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Dr. Bernardo Sepúlveda Gutiérrez, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Servicio de Cirugía Gastrointestinal, Unidad Médica de Alta Especialidad, Hospital de Especialidades Dr. Bernardo Sepúlveda Gutiérrez, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Arch Med Res. 2018 Oct;49(7):504-511. doi: 10.1016/j.arcmed.2019.02.003.
Cell damage in Acute Pancreatitis (AP) lead to release of cytokines and HMGB1 and Hsp70. While Hsp70 plays a role in cytoprotection, when released to extracellular milieu constitutes, as HMGB1, a danger signal and trigger pro-inflammatory responses. These molecules seem to be related to the clinical progression; but because no evidence exists about them as molecular network in AP development, we quantify HSP70, HMGB1, and cytokines in patients with AP and search for correlations with severity and prognosis.
Fifteen patients with AP were included. The average age was 52 years. Six patients had mild pancreatitis, 4 were moderately severe and 5 with a severe form. Blood samples were taken within the first 24 h, at 3d and 7d from the start. Serum HMGB1 and Hsp70 were determined using ELISA; TNF-α, IL-1β, IL-6, IL-8, IL-10 and IL-12p70 were determined by bead based immuassay.
Of all 15 patients recruited, 4 were women. Eight patients had APACHEII score higher than 8. Two patients died from AP related complications. Increase in serum HMGB1 and decrease of Hsp70 were associated with the severity and mortality. TNF-α, IL-6 and IL-8 were higher in patients that did not survive, in those with an APACHE II >8, and in those with severe AP.
High HMGB1 and low Hsp70 were associated with poor prognosis. Hsp70 might play a protective role in AP. TNF-α, IL-6, IL-8, HMGB1 and Hsp70 during hospital admissions might serve to evaluate risk of death due to AP.
急性胰腺炎（AP）中的细胞损伤导致细胞因子和高迁移率族蛋白 B1（HMGB1）和热休克蛋白 70（Hsp70）的释放。虽然 Hsp70 在细胞保护中发挥作用，但当释放到细胞外环境中时，它构成了 HMGB1 作为危险信号并引发促炎反应。这些分子似乎与临床进展有关；但是，由于没有关于它们作为 AP 发展分子网络的证据，我们在 AP 患者中定量测定 HSP70、HMGB1 和细胞因子，并寻找与严重程度和预后的相关性。
纳入 15 例 AP 患者。平均年龄为 52 岁。6 例为轻度胰腺炎，4 例为中度重症胰腺炎，5 例为重度胰腺炎。在发病后 24 小时内、第 3 天和第 7 天采集血液样本。采用 ELISA 法测定血清 HMGB1 和 Hsp70；采用基于珠的免疫测定法测定 TNF-α、IL-1β、IL-6、IL-8、IL-10 和 IL-12p70。
在招募的 15 例患者中，有 4 例为女性。8 例患者的急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分大于 8。2 例患者死于 AP 相关并发症。血清 HMGB1 升高和 Hsp70 降低与严重程度和死亡率相关。未存活患者、APACHEⅡ评分>8 的患者和重症 AP 患者的 TNF-α、IL-6 和 IL-8 更高。
高 HMGB1 和低 Hsp70 与不良预后相关。Hsp70 在 AP 中可能发挥保护作用。住院期间的 TNF-α、IL-6、IL-8、HMGB1 和 Hsp70 可能有助于评估因 AP 死亡的风险。
