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Mei LF, Gan Q, Hu J, Li YX, Tian R, Shi CJ. Assessment of early factors for identification or prediction severe acute pancreatitis in pregnancy. World J Clin Cases 2024; 12:5502-5512. [PMID: 39188606 PMCID: PMC11269993 DOI: 10.12998/wjcc.v12.i24.5502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/25/2024] [Accepted: 06/20/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Acute pancreatitis in pregnancy (APIP) is a rare and serious condition, and severe APIP (SAPIP) can lead to pancreatic necrosis, abscess, multiple organ dysfunction, and other adverse maternal and infant outcomes. Therefore, early identification or prediction of SAPIP is important. AIM To assess factors for early identification or prediction of SAPIP. METHODS The clinical data of patients with APIP were retrospectively analyzed. Patients were classified with mild acute pancreatitis or severe acute pancreatitis, and the clinical characteristics and laboratory biochemical indexes were compared between the two groups. Logical regression and receiver operating characteristic curve analyses were performed to assess the efficacy of the factors for identification or prediction of SAPIP. RESULTS A total of 45 APIP patients were enrolled. Compared with the mild acute pancreatitis group, the severe acute pancreatitis group had significantly increased (P < 0.01) heart rate (HR), hemoglobin, neutrophil ratio (NEUT%), and neutrophil-lymphocyte ratio (NLR), while lymphocytes were significantly decreased (P < 0.01). Logical regression analysis showed that HR, NEUT%, NLR, and lymphocyte count differed significantly (P < 0.01) between the groups. These may be factors for early identification or prediction of SAPIP. The area under the curve of HR, NEUT%, NLR, and lymphocyte count in the receiver operating characteristic curve analysis was 0.748, 0.732, 0.821, and 0.774, respectively. The combined analysis showed that the area under the curve, sensitivity, and specificity were 0.869, 90.5%, and 70.8%, respectively. CONCLUSION HR, NEUT%, NLR, and lymphocyte count can be used for early identification or prediction of SAPIP, and the combination of the four factors is expected to improve identification or prediction of SAPIP.
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Affiliation(s)
- Li-Fen Mei
- Department of Critical Care Medicine, Maternal and Child Health Hospital of Hubei Province, Wuhan 430000, Hubei Province, China
| | - Quan Gan
- Department of Critical Care Medicine, Maternal and Child Health Hospital of Hubei Province, Wuhan 430000, Hubei Province, China
| | - Jing Hu
- Department of Critical Care Medicine, Maternal and Child Health Hospital of Hubei Province, Wuhan 430000, Hubei Province, China
| | - Yun-Xiang Li
- Department of Critical Care Medicine, Maternal and Child Health Hospital of Hubei Province, Wuhan 430000, Hubei Province, China
| | - Rui Tian
- Department of Biliary-Pancreatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Cheng-Jian Shi
- Department of Biliary-Pancreatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Malheiro F, Nascimento ML, Carmo A, Borrego LM. Circulating Blood Lymphocytes and Acute Pancreatitis Severity: A Systematic Review. Cureus 2023; 15:e47532. [PMID: 38022062 PMCID: PMC10664819 DOI: 10.7759/cureus.47532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Acute pancreatitis is an acute inflammatory process of the pancreas with high prevalence and varying degrees of severity that can be potentially life-threatening. Much is still unknown about which mechanisms determine the course and severity of acute pancreatitis. The primary objective of this review is to identify the potential association between circulating lymphocytes and the severity of acute pancreatitis. A systematic search was performed in Medline, Web of Science, Cochrane Central Register of Controlled Trials and ClinicalTrails.gov. The authors independently did the selection process as well as data extraction that was recorded into a flow diagram following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Our initial search identified 27,783 studies which were narrowed down to 13 by applying strict inclusion and exclusion algorithms. The consistent findings across the studies indicated that peripheral blood lymphocytes are related to acute pancreatitis severity.
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Affiliation(s)
| | | | - Ana Carmo
- Internal Medicine, Hospital da Luz Lisboa, Lisboa, PRT
| | - Luis Miguel Borrego
- Immunology, Hospital da Luz Lisboa, Lisboa, PRT
- Immunology, Nova Medical School, Lisboa, PRT
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Güler İ, Ustaalioğlu İ. Predictive power of HALP score in estimating short-term mortality in patients with acute pancreatitis. ULUS TRAVMA ACIL CER 2023; 29:1098-1102. [PMID: 37791438 PMCID: PMC10644086 DOI: 10.14744/tjtes.2023.84970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/15/2023] [Accepted: 08/27/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND To examine the hemoglobin, albumin, lymphocyte, and platelet (HALP) scores' predictive power in predicting short-term mortality from acute pancreatitis (AP). METHODS The study was conducted at the emergency department (ED) of tertiary care hospital. The medical records of patients who admitted to the ED and were diagnosed with AP were reviewed retrospectively. İt was analyzed that the ability of the HALP score in predicting short-term mortality of these patients. RESULTS The study was achieved with a total of 634 patients. The mean age of these patients was 59.7±16.6 and 381 (60.1%) were female. While 42 (6.6%) of the total included patients were required to the intensive care unit, 58 (9.1%) died. To examine the HALP scores' predictive power in predicting short-term mortality, the Receiver Operating Characteristic (ROC) analysis was utilized. The value of the area under the curve was found as 0.891 (95% CI: 0.833-0.949). When the cut-off value of the HALP score in determining short-term mortality is >15, the Sensitivity of the score was found to be 82.8%, Specificity 86.8%, Positive Predictive Value 38.7%, and Negative Predictive Value 98.0%. CONCLUSION AP is a disease that requires early diagnosis and adequate treatment if not it can cause a high rate of mortality and morbidity. As a result of this study, it was concluded that the HALP score can be utilized during the prediction of short-term mortality for patients diagnosed with AP.
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Affiliation(s)
- İlkay Güler
- Republic of Türkiye, Ministry of Health, General Directorate of Public Hospitals, Ankara-Türkiye
| | - İzzet Ustaalioğlu
- Department of Emergency Medicine, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul-Türkiye
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Stojanovic B, Jovanovic IP, Stojanovic MD, Jovanovic M, Vekic B, Milosevic B, Cvetkovic A, Spasic M, Stojanovic BS. The Emerging Roles of the Adaptive Immune Response in Acute Pancreatitis. Cells 2023; 12:1495. [PMID: 37296616 PMCID: PMC10253175 DOI: 10.3390/cells12111495] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/13/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Acute pancreatitis (AP) is an abrupt, variable inflammatory condition of the pancreas, potentially escalating to severe systemic inflammation, rampant pancreatic necrosis, and multi-organ failure. Its complex pathogenesis involves an intricate immune response, with different T cell subsets (Th1, Th2, Th9, Th17, Th22, TFH, Treg, and CD8+ T cells) and B cells playing pivotal roles. Early T cell activation initiates the AP development, triggering cytokines associated with the Th1 response, which stimulate macrophages and neutrophils. Other T cell phenotypes contribute to AP's pathogenesis, and the balance between pro-inflammatory and anti-inflammatory cytokines influences its progression. Regulatory T and B cells are crucial for moderating the inflammatory response and promoting immune tolerance. B cells further contribute through antibody production, antigen presentation, and cytokine secretion. Understanding these immune cells' roles in AP could aid in developing new immunotherapies to enhance patient outcomes. However, further research is required to define these cells' precise roles in AP and their potential as therapeutic targets.
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Affiliation(s)
- Bojan Stojanovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (B.S.)
| | - Ivan P. Jovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | | | - Marina Jovanovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Berislav Vekic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (B.S.)
| | - Bojan Milosevic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (B.S.)
| | - Aleksandar Cvetkovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (B.S.)
| | - Marko Spasic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (B.S.)
| | - Bojana S. Stojanovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
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Wang FJ, Mei X. Expression level of serum miR-347a-5p in patients with acute pancreatitis and its effect on viability, apoptosis, and inflammatory factors of pancreatic acinar cells induced by cerulein. Kaohsiung J Med Sci 2023. [PMID: 36912261 DOI: 10.1002/kjm2.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 03/14/2023] Open
Abstract
Acute pancreatitis (AP) is one of the life-threatening diseases of the digestive system. MicroRNA has been asserted to be a regulator of AP. This paper explored the miR-374a-5p expression in AP patients and investigated the efficacy of AR42J cells. In this study, 60 healthy people, 58 MAP patients and 58 SAP patients were included, and the serum miR-374a-5p levels of the subjects were detected by RT-qPCR technology. The pancreatitis cell model was structured by stimulating AR42J cells with cerulein. Next, cell viability and apoptosis were detected by CCK-8 assay and flow cytometry. ELISA was used to measure the concentration of cytokines, such as TNF-α, IL-6, and IL-1β. The data showed that miR-374a-5p was downregulated in samples from AP patients, while showing discriminative power for AP populations. Attenuated miR-374a-5p were negatively bound up with patients' Ranson score and APACHE II score. Besides, miR-374a-5p was declined in cerulein-treated AR42J cells and forced elevation of miR-374a-5p was beneficial to increase cell viability, and inhibit cell apoptosis and inflammation. The present study found that miR-374a-5p was reduced in AP serum samples, and up-regulated expression level of miR-374a-5p in cell models had a protective effect on cerulein-induced inhibition of cell function and inflammatory response.
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Affiliation(s)
- Fu-Jun Wang
- Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, China
| | - Xue Mei
- Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, China
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Sun HW, Dai SJ, Kong HR, Fan JX, Yang FY, Dai JQ, Jin YP, Yu GZ, Chen BC, Shi KQ. Accurate prediction of acute pancreatitis severity based on genome-wide cell free DNA methylation profiles. Clin Epigenetics 2021; 13:223. [PMID: 34915915 PMCID: PMC8680202 DOI: 10.1186/s13148-021-01217-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/12/2021] [Indexed: 01/15/2023] Open
Abstract
Background Patients with severe acute pancreatitis (SAP) have a high mortality, thus early diagnosis and interventions are critical for improving survival. However, conventional tests are limited in acute pancreatitis (AP) stratification. We aimed to assess AP severity by integrating the informative clinical measurements with cell free DNA (cfDNA) methylation markers. Methods One hundred and seventy-five blood samples were collected from 61 AP patients at multiple time points, plus 24 samples from healthy individuals. Genome-wide cfDNA methylation profiles of all samples were characterized with reduced representative bisulfite sequencing. Clinical blood tests covering 93 biomarkers were performed on AP patients within 24 h. SAP predication models were built based on cfDNA methylation and conventional blood biomarkers separately and in combination. Results We identified 565 and 59 cfDNA methylation markers informative for acute pancreatitis and its severity. These markers were used to develop prediction models for AP and SAP with area under the receiver operating characteristic of 0.92 and 0.81, respectively. Twelve blood biomarkers were systematically screened for a predictor of SAP with a sensitivity of 87.5% for SAP, and a specificity of 100% in mild acute pancreatitis, significantly higher than existing blood tests. An expanded model integrating 12 conventional blood biomarkers with 59 cfDNA methylation markers further improved the SAP prediction sensitivity to 92.2%. Conclusions These findings have demonstrated that accurate prediction of SAP by the integration of conventional and novel blood molecular markers, paving the way for early and effective SAP intervention through a non-invasive rapid diagnostic test. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01217-z.
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Affiliation(s)
- Hong-Wei Sun
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Sheng-Jie Dai
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong-Ru Kong
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jie-Xiang Fan
- Translational Medicine Laboratory, Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, No. 1 FanHai West Road, OuHai, Wenzhou, 325000, China
| | - Fang-Yuan Yang
- Translational Medicine Laboratory, Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, No. 1 FanHai West Road, OuHai, Wenzhou, 325000, China
| | - Ju-Qing Dai
- Translational Medicine Laboratory, Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, No. 1 FanHai West Road, OuHai, Wenzhou, 325000, China
| | - Yue-Peng Jin
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guan-Zhen Yu
- Translational Medicine Laboratory, Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, No. 1 FanHai West Road, OuHai, Wenzhou, 325000, China
| | - Bi-Cheng Chen
- Translational Medicine Laboratory, Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, No. 1 FanHai West Road, OuHai, Wenzhou, 325000, China
| | - Ke-Qing Shi
- Translational Medicine Laboratory, Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, No. 1 FanHai West Road, OuHai, Wenzhou, 325000, China. .,Key Laboratory of Intelligent Critical Care and Life Support Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Can we use endocan level to determine severity of pancreatitis? Acta Gastroenterol Belg 2021; 84:321-325. [PMID: 34217183 DOI: 10.51821/84.2.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background and study aims Endothelial cell specific molecule-1 (ESM-1), also known as endocan, is a soluble proteoglycan secreted by human vascular endothelial cells. In some studies, it has been found that endocan have important effects on cell adhesion, inflammation and angiogenesis. In this study, we aimed to evaluate the endocan level in patients with pancreatitis and the availability of endocan level in determining the severity of the disease. Patients and methods A total of 42 patients with pancreatitis and 33 healthy individuals were included in the study. The serum endocan levels in patients were evaluated 1st and 3 th days after the symptom's onset. Current scoring systems and the relationship between the severity of the disease and endocan levels were evaluated. Results The endocan levels of the patients on day 1 are significantly correlated only with the APACHE II score (p=0.039 r=0.319), while the endocan values on day 3 are significantly correlated with the BISAP (bedside index of severity in acute pancreatitis) (p=0.013 r=0.380), APACHE II (Acute Physiology and Chronic Health Evaluation)(p<0.001; r=0.53) and Ranson (p=0.037 r=0.32) scores. The cutoff level of endocan (day 3) was calculated 92.2 pg/ml (83% sensitivity and 50% specificity; p=0.039 area under the curve 0.706) for severe pancreatitis when considering the patients with a score of 8 or higher in the APACHE II scoring system. Conclusion Serum endocan level can be used as a marker of prognosis in patients with pancreatitis. However, studies involving large populations are needed on this matter.
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Jin X, Ding Z, Li T, Xiong J, Tian G, Liu J. Comparison of MPL-ANN and PLS-DA models for predicting the severity of patients with acute pancreatitis: An exploratory study. Am J Emerg Med 2021; 44:85-91. [PMID: 33582613 DOI: 10.1016/j.ajem.2021.01.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/27/2020] [Accepted: 01/16/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Acute pancreatitis (AP) is a common inflammatory disorder that may develop into severe AP (SAP), resulting in life-threatening complications and even death. The purpose of this study was to explore two different machine learning models of multilayer perception-artificial neural network (MPL-ANN) and partial least squares-discrimination (PLS-DA) to diagnose and predict AP patients' severity. METHODS The MPL-ANN and PLS-DA models were established using candidate markers from 15 blood routine parameters and five serum biochemical indexes of 133 mild acute pancreatitis (MAP) patients, 167 SAP (including 88 moderately SAP) patients, and 69 healthy controls (HCs). The independent parameters and combined model's diagnostic efficiency in AP severity differentiation were analyzed using the area under the receiver operating characteristic curve (AUC). RESULTS The neutrophil to lymphocyte ratio (NLR) is the most useful marker in 20 parameters for screening AP patients [AUC = 0.990, 95% confidence interval (CI): 0.984-0.997, sensitivity 94.3%, specificity 98.6%]. The MPL-ANN model based on six optimal parameters exhibited better diagnostic and predict performance (AUC = 0.984, 95% CI: 0.960-1.00, sensitivity 92.7%, specificity 93.3%, accuracy 93.0%) than the PLS-DA model based on five optimal parameters (AUC = 0.912, 95% CI: 0.853-0.971, sensitivity 87.8%, specificity 84.4%, accuracy 84.8%) in discriminating MAP patients from SAP patients. CONCLUSION The results demonstrated that the MPL-ANN model based on routine blood and serum biochemical indexes provides a reliable and straightforward daily clinical practice tool to predict AP patients' severity.
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Affiliation(s)
- Xinrui Jin
- Department of Laboratory Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Zixuan Ding
- Department of Laboratory Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Tao Li
- Network manage center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Jie Xiong
- Department of Laboratory Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China; Department of Laboratory Medicine, General Hospital of Chengdu Military Region, Chengdu, Sichuan 610083, China
| | - Gang Tian
- Department of Laboratory Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Jinbo Liu
- Department of Laboratory Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China.
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Guo J, Li Z, Tang D, Zhang J. Th17/Treg imbalance in patients with severe acute pancreatitis: Attenuated by high-volume hemofiltration treatment. Medicine (Baltimore) 2020; 99:e21491. [PMID: 32756180 PMCID: PMC7402917 DOI: 10.1097/md.0000000000021491] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To investigate the effect of high-volume hemofiltration (HVHF) on Th17/Treg imbalance in patients with severe acute pancreatitis (SAP). METHODS Forty-two patients with SAP were randomly received 24 hours of continuous HVHF (n = 21) or without HVHF (n = 21). At day 28, all 42 patients were divided into survival group (n = 32) and non-survival group (n = 10). Venous blood samples collected at 0, 6, 12, and 24 hours during HVHF treatment (or equivalent time in non-HVHF group) were assessed by flow cytometry to detect Th17 and Treg cells. Concentrations of IL-6, IL-17, IL-10, and TGF-β1 were detected by enzyme-linked immunosorbent assay. RESULTS Th17%, Treg%, Th17/Treg, and levels of related cytokines were significantly higher in SAP patients than healthy controls (P < .05), and these changes were more pronounced in SAP patients with multiple organ failure than those with single organ failure (P < .05). After HVHF treatment, Th17%, Treg%, Th17/Treg, IL-6, IL-17, and IL-10 significantly reduced (P < .05), while there were no significant changes in non-HVHF group (P > .05). In addition, acute physiology and chronic health evaluation II and sequential organ failure assessment scores decreased markedly after HVHF treatment. Baselines of Th17%, Treg%, Th17/Treg, and related cytokines were significantly higher in non-survival group than survival group. Both acute physiology and chronic health evaluation I score and IL-6 level were positively correlated with Th17% before and after HVHF treatment (P < .01). CONCLUSIONS Th17/Treg imbalance is present in SAP and may be correlated with its severity and prognosis. HVHF effectively attenuates the Th17/Treg imbalance in SAP patients. The beneficial effect of HVHF on Th17/Treg imbalance is possibly associated with removing excess inflammatory mediators.
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Affiliation(s)
- Jiguang Guo
- Department of Nephrology,People's Hospital of Rongchang District
| | - Zhen Li
- Department of Nephrology, Yongchuan Hospital of Chongqing Medical University
| | - Dan Tang
- Department of Nephrology, Yongchuan Hospital of traditional Chinese Medicine, Chongqing, China
| | - Jianbin Zhang
- Department of Nephrology, Yongchuan Hospital of Chongqing Medical University
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Zhou Q, Tao X, Xia S, Guo F, Pan C, Xiang H, Shang D. T Lymphocytes: A Promising Immunotherapeutic Target for Pancreatitis and Pancreatic Cancer? Front Oncol 2020; 10:382. [PMID: 32266154 PMCID: PMC7105736 DOI: 10.3389/fonc.2020.00382] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/04/2020] [Indexed: 01/18/2023] Open
Abstract
Pancreatic disorders cause a broad spectrum of clinical diseases, mainly including acute and chronic pancreatitis and pancreatic cancer, and are associated with high global rates of morbidity and mortality. Unfortunately, the pathogenesis of pancreatic disease remains obscure, and there is a lack of specific treatments. T lymphocytes (T cells) play a vital role in the adaptive immune systems of multicellular organisms. During pancreatic disease development, local imbalances in T-cell subsets in inflammatory and tumor environments and the circulation have been observed. Furthermore, agents targeting T cells have been shown to reverse the natural course of pancreatic diseases. In this review, we have discussed the clinical relevance of T-cell alterations as a potential outcome predictor and the underlying mechanisms, as well as the present status of immunotherapy targeting T cells in pancreatitis and neoplasms. The breakthrough findings summarized in this review have important implications for innovative drug development and the prospective use of immunotherapy for pancreatitis and pancreatic cancer.
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Affiliation(s)
- Qi Zhou
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Xufeng Tao
- School of Chemical Engineering, Dalian University of Technology, Dalian, China
| | - Shilin Xia
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Fangyue Guo
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Chen Pan
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Department of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hong Xiang
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dong Shang
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Department of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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Zhao Z, Shen J, Zhang D, Shen J. The Prognostic Role of Peripheral Lymphocyte Subsets in Patients With Acute Pancreatitis. Am J Med Sci 2018; 357:242-246. [PMID: 30797505 DOI: 10.1016/j.amjms.2018.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND The prognostic role of peripheral lymphocyte subsets in early stage of acute pancreatitis (AP) is unknown. METHODS After enrollment, blood samples were collected in the first 24 hours of the onset of AP in 164 patients. The lymphocyte count and the percentage of CD3+, CD3+CD4+, CD3+CD8+, CD3-CD19+and CD3-CD (16 + 56)+ cells were assessed. RESULTS Reduction of the lymphocyte count and the percentage of CD3+CD8+ and CD3-CD (16 + 56)+ cells within 24 hours of the onset of AP as well as an increase in the percentage of CD3+ and CD3+CD4+ cells were observed. The percentage of CD3-CD (16 + 56)+ cells had the highest accuracy in prediction of AP severity. CONCLUSIONS Marked changes of the percentages of lymphocyte subset were found in peripheral blood in the early stage of AP. The percentage of CD3-CD (16 + 56)+ cells in peripheral blood could be a potent prognostic predictor.
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Affiliation(s)
- Ziqiang Zhao
- Department of General Surgery, The Fifth People's Hospital of Changshu, Changshu, Jiangsu, China
| | - Jie Shen
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Deqing Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
| | - Jiaqing Shen
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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