Abstract
As an important ligand in T lymphocyte costimulatory pathways, B7-H5 is involved deeply in the immune response in various diseases. However, its clinical usefulness as an early indicator in acute pancreatitis (AP) remains unclear. In this study, the levels of sB7-H5 and cytokines in plasma samples of 75 AP patients, 20 abdominal pain patients without AP, and 20 healthy volunteers were determined. Then, the correlation of sB7-H5 and clinical features, cytokines, the Ranson score, APACHE II score, Marshall score, and BISAP score was analysed, and the value of sB7-H5 for diagnostic, severity, and prognosis of AP was evaluated. We found that the levels of sB7-H5 were specifically upregulated in AP patients. Receiver operating characteristic (ROC) analysis revealed that sB7-H5 can identify AP patients from healthy or abdominal pain patients with 78.9% or 86.4% sensitivity and 93.3% or 90.0% specificity. Further analysis showed that the levels of sB7-H5 were significantly correlated with WBC (p = 0.004), GLU (p = 0.008), LDH (p < 0.001), Ca2+ (p = 0.006), AST (p = 0.009), PLT (p = 0.041), IL-6 (p < 0.001), IL-10 (p < 0.001), and TNF-α (p < 0.001). And levels of sB7-H5 were gradually increased among patients with mildly acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). It can distinguish the severity of AP with good sensitivity and specificity. Moreover, when dividing the patients into two groups according to the median level of sB7-H5, the local complication and length of stay of low levels of the sB7-H5 group were significantly less than those in high levels of the sB7-H5 group. And the levels of sB7-H5 in AP patients were significantly correlated with the Ranson score (p < 0.001), APACHE II score (p < 0.001), Marshall score (p < 0.001), and BISAP score (p < 0.001). The AUCs of assessing local complications of sB7-H5 at day 1 and day 3 were 0.704 (p = 0.0024) and 0.727 (p = 0.0373). These results showed the potential value of sB7-H5 as a diagnostic, severity, and prognosis marker of AP.
Highlights
Acute pancreatitis (AP) is a severe inflammation of the pancreas caused by local pancreatic damage, which may lead to multiorgan failure or death
There were no significant differences in age and sex among the three groups, and the levels of cytokines such as IL-6, IL-10, and TNF-α were significantly upregulated in AP patients, which were in line with
The results indicated that soluble B7-H5 (sB7-H5) levels were increased in AP patients
Summary
Acute pancreatitis (AP) is a severe inflammation of the pancreas caused by local pancreatic damage, which may lead to multiorgan failure or death. The incidence of acute pancreatitis ranges from 13 to 45 per 100,000 population years, and it is rising worldwide probably due to a combination of risk factors, such as obesity, alcohol abuse, and gallstone disease [1,2,3]. According to the Revised Atlanta Classification, acute pancreatitis could be classified as mild AP (MAP), moderately severe AP (MSAP), and severe AP (SAP). The majority of patients (80%–85%) suffer from MAP with a mortality rate less than 3%, the patients developing severe acute pancreatitis (SAP) have a mortality rate of 13–35% [4]. A good accurate predictor of the clinical course of AP to identify patients with risk of developing complications or death is essential in AP therapy [5]
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