Disorders of Immune Response in Patients With Acute Necrotic Pancreatitis

Abstract

Summary. Aim. To study the cytokine regulation of the immune response in patients with severe acute necrotic pancreatitis (ANP).
 Material and methods. A prospective cohort study of 22 patients with severe ANP who were treated in the clinic during 2014-2020 has been performed. We studied changes in blood cells expressing clusters CDIIa+, CD162+, CD95+, CD16+, HLA-DR+ molecules, levels of interleukins IL-2, IL-4, IL-6. The efficacy of treatment was determined by the duration of the organ failure, the level of postoperative complications and mortality.
 Results. Low expression of CD11a+ and CD162+ on immunocompetent cells together with two time reduction of the content of CD95+ cells was observed in patients with severe ANP, which caused a decrease in the concentration of IL-6 at the same time with a slight increase in IL-4. A permanent reduction of the content of CD11a+-, CD162+- and CD95+-leukocytes simultaneously with a drop of the concentration of IL-4 and an excessive increase in the levels of IL-2 and IL-6 was associated with a negative course of the disease.
 Conclusions. The imbalance of cytokine regulation of the immune response develops in patients with severe ANP. Progressive and excessive increase of plasma concentrations of IL-2 and IL-6 occurs as well as complete absence of IL-4 occurs in patients with an adverse course of the disease.