Abstract
Early stratification of the severity of acute pancreatitis (AP) is clinically important. Regulatory B cells have been found to be associated with disease activity of autoimmune diseases. However, the role of Regulatory B cells in AP remains unknown. We investigate the dynamic longitudinal changes in circulating IL-10-producing B cells (B10) and memory CD19+CD24hiCD27hi cells in patients with AP to evaluate their prediction utility for AP severity. B10, CD19+CD24hiCD27hi cells, inflammatory markers and cytokines were detected in patients with AP immediately after admission to the hospital (day 1), then on the third and seventh days. We observed decreases in lymphocytes, CD19+, B10, CD19+CD24hiCD27hi cells and lower mean fluorescence intensity (MFI) of CD80 and CD86 on B10 or CD19+CD24hiCD27hi cells in patients with AP, especially in those with severe acute pancreatitis (SAP). CD19+CD24hiCD27hi cells from patients with AP suppressed the cytokine productions of CD4+ T cells and CD14+ monocytes, but had impaired ability to induce regulatory T cells response. B10 and CD19+CD24hiCD27hi cells significantly increased in patients with mild acute pancreatitis (MAP) from day 1 to day 7, whereas these indexes remained stable in patients with SAP. B10 or CD19+CD24hiCD27hi cells were negatively correlated with the severity index (APACHE II score), inflammatory markers (C-reactive protein, CD64 index), and cytokines (IL-6, IL-17, TNF-α). Furthermore, receiver operating characteristic (ROC) curve analysis revealed that B10 and CD19+CD24hiCD27hi cells could predict the development of SAP. Thus, the detection of B10 and CD19+CD24hiCD27hi cells may be a practical way to improve the early assessment of AP severity.
Highlights
The severity and course of acute pancreatitis (AP) are difficult to evaluate by assessing the first symptoms and clinical signs alone
Because B10 and CD19+CD24hiCD27hi cells were significantly decreased in patients with AP, we investigated the expression of the activation markers CD80 and CD86 by immunofluorescence staining and flow cytometry to determine whether a difference was present in the activation status of B10 or CD19+CD24hiCD27hi cells between patients with AP and healthy individuals
As previously reported [21], our results showed that the serum levels of IL-6, IL-10, IL-17, TNF-α and TGF-β were all increased in patients with mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP) compared with the corresponding levels in healthy individuals; these levels were increased along with AP severity, and a significant difference was observed between patients with MAP and SAP
Summary
The severity and course of acute pancreatitis (AP) are difficult to evaluate by assessing the first symptoms and clinical signs alone. It is mostly self-limiting, approximately 20–30% of all patients will progress to a severe form, which has approximately a 5% mortality rate [1, 2]. CD14+HLA-DRlow/- cells, the myeloid-derived suppressor cells with immunosuppressive lymphocyte function, have been shown to predict the development of organ failure and a fatal outcome [7]. These methods in the prediction of AP severity have limitations in the clinical practice. Research has focused on the search for novel biochemical markers that can predict AP severity in the initial 24 h following admission
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
