Behavior of Serum Soluble lnterleukin-2 Receptor, Soluble CD8 and Soluble CD4 in the Early Phases of Acute Pancreatitis

Abstract

When activated, lymphocytes secrete glycoproteins related to particular surface proteins, including soluble forms of the interleukin-2 receptor (sIL-2R) and of the surface proteins CD4 (sCD4) and CD8 (sCD8). We evaluated the release of these glycoproteins in order to assess the activation of the cellular immune system during the course of acute pancreatitis. Thirty-five patients with acute pancreatitis (22 M, 13 F, mean age 64 years, range 16-97) were studied. The diagnosis was based on typical abdominal pain associated with a twofold increase of serum lipase as well as morphological abnormalities compatible with acute pancreatitis seen at computed tomography and/or ultrasonography. The pancreatitis was of biliary origin in 22 patients, due to alcohol abuse in 8, due to pancreas divisum inl, due to type IV hyperlipoproteinemia in 1 and of unknown origin in 3. Based on clinical outcome, 22 patients had mild pancreatitis, whereas 13 had severe disease. In all patients serum sIL-2R, sCD4 and sCD8 were determined on admission and daily for the following 5 days using enzyme immunoassay (ElA) techniques. Serum concentrations of sIL-2R and sCD8 were significantly higher in acute pancreatitis patients relative to healthy controls during the entire observation period, whereas sCD4 levels were significantly lower in acute pancreatitis patients than in the control group from the 2nd to the 6th day of observation. Serum sIL·2R concentrations were significantly higher in patients with severe pancreatitis than in those with the mild form of the disease, whereas no differences in serum concentrations of sCD8 and sCD4 were found between patients with mild pancreatitis and those with severe disease. No differences in serum levels of sIL·2R, sCD8 and sCD4 were found between patients with biliary pancreatitis and those with other etiologic forms of the disease. The results indicate that in the early phases of acute pancreatitis there is an activation of the cellular suppres-sor-cytotoxic immune system and impaired activity of the CD4 T lymphocytes; furthermore, serum sIL-2R may be helpful in early assessment of the severity of this disease.

Impaired Lymphocyte Proliferation in Human Acute Pancreatitis

“…[3], The authors of both studies also noted that a sustained anergic state was associated with pancreatic septic complications. Recently, we ob served that in patients with acute pancreatitis there is a significant decrease in the absolute number of the periph eral total lymphocytes and their subpopulations [1], Fur thermore, in comparison with patients having the mild form of the disease, patients with severe acute pancreatitis had a significantly lower number of total, T and T-helper lymphocytes [1], We also reported low scrum values of soluble CD4 [9] thus suggesting an impaired activity of the CD4+ T lymphocytes. Table 2.…”

“…sCD4. sCD8, TNF) have been found to be altered in patients with acute pancreatitis [3][4][5][6][7][8][9]. However, there are no data about lymphocyte proliferation in patients with acute pancreatitis.…”

Acute Pancreatitis: The Pathophysiological Role of Cytokines and Integrins

“…Reduced IL-2 production in experimental AP has recently been reported [148]. Moreover, soluble IL-2 receptor (sIL-2R) has been shown to be elevated in patients with severe AP than in healthy controls, and positively correlated with the severity of the attack [149]. Since released IL-2R is known to bind IL-2, it has been hypothesized that sIL-2R may act as an antagonist to IL-2-mediated cell responses, thus downregulating T-cell IL-2 production [149].…”

Study on the Relationship of APACHE III and Levels of Cytokines in Patients with Systemic Inflammatory Response Syndrome after Coronary Artery Bypass Grafting

“…It can combine with the membrane IL-2 receptor and then stimulates the maturity of T cells, enhances the function of natural killer cells and accelerates the secretion of immunoglobulins. Some authors 12) have found that soluble IL-2 receptors can competitively combine with IL2, resulting in the formation of an immunosuppressive complex and a decrease in the function of IL2. Although the mechanism and clinical significance of the elevation of sIL-2R levels after cardiac surgery is not clear, the decrease in IL2 and increase in sIL-2R are harmful for the immune defense system.…”