CYTOKINE REGULATION OF THE IMMUNE RESPONSE IN PATIENTS WITH ACUTE NECROTIC PANCREATITIS COMPLICATED BY MULTI-ORGANIC FAILURE
Aim: To study the cytokine regulation of the immune response in patients with acute necrotic pancreatitis (ANP) complicated by multiple organ failure (MON).
Material and methods: A prospective cohort study of 22 patients with ANP complicated by MON 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 ANP complicated by MON, 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 ANP, complicated by MON. 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.
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