Early mean absolute lymphocyte count in acute necrotizing pancreatitis is associated with infected pancreatic necrosis

Cai, Tianbin; Mao, Wenjian; Liu, Meiqiong; Zhou, Jing; Wang, Xinyu; Liu, Yuxiu; Lv, Guangyu; Ke, Lu; Zhang, Youhua

doi:10.1016/j.intimp.2023.109883

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…However, most of these markers are not readily available in hospitals. Through a post-hoc analysis of the TRACE trial[ 14 ], Cai et al [ 15 ] found that absolute lymphocyte count (ALC), a more readily available clinical measure, can predict the occurrence of IPN. Since ALC is a routine laboratory measurement, it might be of wider clinical use in practice.…”

Section: Early Prediction Of Ipnmentioning

confidence: 99%

Early prediction and prevention of infected pancreatic necrosis

Lv,

Zhang,

2024

World J Gastroenterol

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Approximately 20%-30% of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis (IPN), a highly morbid and potentially lethal complication. Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes. In the past two decades, several markers and predictive tools have been proposed and evaluated for this purpose. Conventional biomarkers like C-reactive protein, procalcitonin, lymphocyte count, interleukin-6, and interleukin-8, and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN. On the other hand, scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested, and the results showed that they may provide better accuracy. For early prevention of IPN, several new therapies were tested, including early enteral nutrition, antibiotics, probiotics, immune enhancement, etc. , but the results varied. Taken together, several evidence-supported predictive markers and scoring systems are readily available for predicting IPN. However, effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition. In this editorial, we summarize evidence concerning early prediction and prevention of IPN, providing insights into future practice and study design. A more homogeneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN, thereby achieving individualized treatment.

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Section: Early Prediction Of Ipnmentioning

confidence: 99%

Early prediction and prevention of infected pancreatic necrosis

Lv,

Zhang,

2024

World J Gastroenterol

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“…The progression from AP to sepsis has been a focal point of recent research, seeking to understand the underlying mechanisms. Studies have identified key factors contributing to this progression, including a decrease in peripheral absolute lymphocyte count has been associated with a higher incidence of IPN ( 7 ). Furthermore, the downregulation of HLA-DR and alterations in the Kynurenine pathway, which have been linked to the onset of IPN during AP ( 8 ), and treatments like thymosin alpha 1, aimed at enhancing immunity, show potential in reducing the occurrence of IPN in AP patients ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Unraveling the immunological landscape in acute pancreatitis progression to sepsis: insights from a Mendelian randomization study on immune cell traits

Liu,

Wang,

Zhao

et al. 2024

Front. Immunol.

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BackgroundAcute pancreatitis (AP) is a severe digestive system disorder with a significant risk of progressing to sepsis, a major cause of mortality. Unraveling the immunological pathways in AP is essential for developing effective treatments, particularly understanding the role of specific immune cell traits in this progression.MethodsEmploying a bidirectional two-sample Mendelian Randomization (MR) approach, this study first examined the causal relationship between AP and 731 immune cell traits to identify those significantly associated with AP. Subsequently, we explored the causal associations between 731 immune cell traits and sepsis. The analysis utilized extensive genome-wide association studies (GWAS) summary datasets, with a focus on identifying common immune cell traits with statistically significant causal associations between AP and sepsis.ResultsOur investigation identified 44 immune cell traits unidirectionally associated with AP and 36 traits unidirectionally associated with sepsis. Among these, CD127 on CD28+ CD45RA- CD8+ T cells emerged as a common mediator, accounting for 5.296% of the increased risk of sepsis in AP patients. This finding highlights the significant role of specific memory CD8+ T cells in the pathophysiology of AP and its progression to sepsis.ConclusionThis study elucidates the critical role of specific immune cell traits, particularly CD127hi memory CD8+ T cells, in the progression of AP to sepsis. Our findings provide a foundation for future research into targeted immune-modulatory therapies, potentially improving patient outcomes in AP-related sepsis and offering new insights into the complex immunological dynamics of this condition.

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Early mean absolute lymphocyte count in acute necrotizing pancreatitis is associated with infected pancreatic necrosis

Cited by 2 publications

References 33 publications

Early prediction and prevention of infected pancreatic necrosis

Early prediction and prevention of infected pancreatic necrosis

Unraveling the immunological landscape in acute pancreatitis progression to sepsis: insights from a Mendelian randomization study on immune cell traits

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