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.
2. Usenko OY, Kopchak VM, Khomiak IV, Khomiak AI, Malik AV. Results of surgical treatment of paraduodenal (groove) pancreatitis. Klinicheskaia Khirurgiia. 2019;85(11):5-8. doi:10.26779/2522-1396.2018.11.05 [In Ukr.]
3. Dronov ОІ, Nastashenko ІL, Susak YМ, Tsymbalyuk RS, Тyulyukin ІО. Surgical treatment of patients, suffer in an acute biliary pancreatitis and biliary hypertension. Klinicheskaia Khirurgiia. 2018;85(4):5-8. doi:10.26779/2522-1396.2018.04.05 [In Ukr.]
4. Takeyama Y. Clinical feature and pathophysiology of acute pancreatitis. Nihon Shokakibyo Gakkai Zasshi. 2016;113(8):1345-50. doi:10.11405/nisshoshi.113.1345
5. Rotar O, Khomiak I, Rotar V, Khomiak A, Shafraniuk V, Poliansky O. Determination of grade of gastrointestinal injury and its prognostic utility in patients with acute necrotizing pancreatitis. Med.-Surg. J. - Revista Med.-Chir. 2018;122(4):759-65. doi:revmedchir.ro/index.php/revmedchir/article/view/1593
6. Koziel D, Gluszek S, Matykiewicz J. Comparative analysis of selected scales to assess prognosis in acute pancreatitis. Can. J. Gastroenterol. Hepatol. 2015;29(6): 299-303. doi: 10.1155/2015/392643
7. Savoliuk SI, Tomashevsky YV, Melnik TO. Treatment and prevention of hepatic failure in acute biliary pancreatitis in patients with diabetes mellitus. International Journal of Endocrinology. 2017;13(7):478-85. doi:10.22141/2224-0722.214.171.1247.115746 [In Ukr.]
8. Guo Q, Li AQ. The role of organ failure and infection in necrotizing pancreatitis: a prospective study. Ann. Surg. 2014;259(6):1201-7. doi: 10.1097/SLA.0000000000000264
9. Maksymiuk VV, Hrynchuk FV, Tarabanchuk VV. Analiz dynamiky zmin pokaznykiv tsytokinovoho statusu pry hostromu nekrotychnomu pankreatyti. Art of medicine. 2017;2:20-6. doi:art-of-medicine.ifnmu.edu.ua/index.php/aom/article/view/242 [In Ukr.]