HLA-DR expression in acute pancreatitis.
OBJECTIVE
To investigate the role of the monocyte/macrophage system in acute pancreatitis


METHODS
Prospective clinical study


METHODS
University clinic, Germany


METHODS
37 consecutive patients who presented with acute pancreatitis.


METHODS
Correlation between function of monocytes measured by HLA-DR expression and outcome


RESULTS
Patients were divided into three groups according to outcome: those with severe pancreatitis who died (n = 10), those with severe pancreatitis who survived (n = 15), and those with mild pancreatitis who survived (n = 12). There was a clear and significant difference between those with severe and those with mild disease. HLA-DR expression was initially depressed in both groups, but after the third day of treatment it started to recover significantly in those with mild disease (p < 0.05). The difference was also significant from day 7 onwards between those with severe disease who died and those with severe disease who survived (p < 0.05).


CONCLUSIONS
Monocyte function as measured by HLA-DR expression (CD14+DR+) is reduced in patients with acute pancreatitis and does not recover in patients who are going to die (median < 20 relative antigen density units; RU).
Richter
A
A
Department of Surgery, Universitätsklinikum Mannheim, University of Heidelberg, Mannheim, Germany.
Nebe
T
T
Wendl
K
K
Schuster
K
K
Klaebisch
G
G
Quintel
M
M
Lorenz
D
D
Post
S
S
Trede
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D008264:Macrophages / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D019283:Pancreatitis, Acute Necrotizing / Q000276:immunology* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate
D006684:HLA-DR Antigens; D002097:C-Reactive Protein