Dynamic Detection of Monocyte Subsets in Peripheral Blood of Patients with Acute Hypertriglyceridemic Pancreatitis.

Junyuan Zheng,Chunlan Huang,Zehua Huang,Xingpeng Wang,Yue Zeng,Yingying Lu,Junjie Fan

doi:10.1155/2019/5705782

Abstract

Aim Monocytes play an important role in acute pancreatitis (AP). Hypertriglyceridemic pancreatitis (HTGP) is always more severe than normal lipid-AP, whether the mechanism of aggravation involves monocyte subsets remains unknown though. The present study was aimed to analyze changes of peripheral blood M1 and M2 monocytes in HTGP patients. Methods A total of 90 subjects were enrolled, among which 16 diagnosed with HTGP, 34 with acute biliary pancreatitis (ABP), 20 with hypertriglyceridemia (HTG), and 20 healthy controls (HC). Peripheral blood CD14+CD86+ M1 and CD14+CD206+ M2 monocytes were examined by flow cytometry on days 1, 3, and 7 after admission. Results We found a marked increase in total and M1 monocyte count in AP patients (P < 0.05). In HTGP, the percentage of M1 monocytes in white blood cells was significantly higher on days 1, 3, and 7, while M2 monocyte percentage was decreased on day 3, compared with ABP (P < 0.05). In mild HTGP, M1 monocyte count and percentage gradually decreased, while M2 monocyte percentage gradually increased from day 1 to 7. In severe HTGP, M1 monocyte count and percentage rose to the highest point while M2 were the lowest on day 3. Additionally, the level of M1 monocytes showed a positive correlation with plasma triglyceride and Ranson score of HTGP patients. Conclusions Peripheral blood M1 and M2 monocytes showed different dynamic changes in mild and severe HTGP. A more dominant role of CD14+CD86+ M1 monocytes may be involved in the pathogenesis of HTGP.

Highlights

Hypertriglyceridemia (HTG) is the third most common etiology of acute pancreatitis (AP), secondary to gallstones and alcohol abuse [1]
A more dominant role of CD14+CD86+ M1 monocytes may be involved in the pathogenesis of hypertriglyceridemic pancreatitis (HTGP)
For the first time, we found that the percentage of M1 monocytes in white blood cells was significantly higher on days 1, 3, and 7, while M2 monocyte percentage was decreased on day 3 in HTGP, compared with acute biliary pancreatitis (ABP)

Summary

Introduction

Hypertriglyceridemia (HTG) is the third most common etiology of acute pancreatitis (AP), secondary to gallstones and alcohol abuse [1]. AP patients are generally categorized as having hypertriglyceridemic pancreatitis (HTGP) when triglyceride (TG) level exceeds 1000 mg/mL or between 500 and 1000 mg/mL but with lipemic serum [2]. Both clinical and experimental studies have demonstrated that compared with acute biliary pancreatitis (ABP), HTGP is more severe and displays aggravated inflammation [3, 4]. Monocytes are an important type of white blood cells (WBCs) and differentiate into tissue macrophages when they leave the circulation system. M1 and M2 subsets express different activation markers, among which CD68 and CD206 are routinely used to identify the M1 and M2 phenotype, respectively [7, 8]. Zhang et al [9] reported increased numbers of CD14+CD163- monocytes, CD14+CD163MAC387+ M1 monocytes, and CD14+CD163+CD115+ M2 monocytes in patients with new-onset mild AP, the latter was suggested to be important factor in determining the severity and prognosis of severe AP [10]

Methods

Discussion

Conclusion