title: Immune dysregulation in patients with severe acute pancreatitis.
abstract: To investigate patients with severe acute pancreatitis (SAP) by dynamic levels of pro-/anti-inflammatory cytokines and endotoxin (ET) in plasma and the relationship between immunity and infection, organ dysfunction. Seventy-two patients with SAP were recruited. The ET, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-4 (IL-4) were determined on admission and days 3, 7, and 14. For comparison, patients were analyzed through infection group versus non-infection group, multiple organ dysfunction syndrome (MODS) group versus non-MODS group. There were sixteen patients with secondary infection, twenty-two with MODS, and nine deaths. The infection group had higher levels of ET than the non-infection group on days 3 and 7. The dynamic cytokine levels of patients in the MODS group were unanimous with those outcomes in the infection group. The levels of cytokines in the infection group were different from the non-infection group, with more levels of TNF-α, IL-6 on days 3 and 7 and less on days 14, and more levels of IL-10, IL-4 on days 7 and 14. The levels of TNF-α, IL-6 in the MODS group were different from the non-MODS group, with more levels on days 3 and 7, and less levels on days 14. Immune dysregulation may play an important role in infection and organ dysfunction for patients with SAP.
authors.affiliation: National Medical Center of Biliopancreatic Diseases, Nankai Hospital, Nankai Clinical School, Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: YinFeng
authors.initials: Y
authors.lastname: Shen
authors.forename: NaiQiang
authors.initials: N
authors.lastname: Cui
authors.forename: Bing
authors.initials: B
authors.lastname: Miao
authors.forename: ErPeng
authors.initials: E
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood*; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications*; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D010195:Pancreatitis / Q000150:complications* / Q000276:immunology* / Q000401:mortality; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D004731:Endotoxins; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4
references.citation: World J Gastroenterol. 2007 Oct 14;13(38):5043-51
references.pmid: 17876868
references.citation: Crit Care Med. 2004 Dec;32(12):2457-63
references.pmid: 15599151
references.citation: Pancreas. 2009 Mar;38(2):122-5
references.pmid: 18797421
references.citation: Pancreas. 2004 Mar;28(2):211-3
references.pmid: 15028955
references.citation: J Gastroenterol. 2006 Aug;41(8):779-84
references.pmid: 16988767
references.citation: Pancreas. 2008 Apr;36(3):e10-5
references.pmid: 18362832
references.citation: Crit Care Med. 1992 Jun;20(6):864-74
references.pmid: 1597042
references.citation: Pancreas. 2005 Mar;30(2):e46-50
references.pmid: 15714129
references.citation: Pancreas. 2003 Jan;26(1):18-22
references.pmid: 12499912
references.citation: Cytokine. 2002 Jan 7;17(1):53-9
references.pmid: 11886171
references.citation: Am J Respir Cell Mol Biol. 2006 Aug;35(2):198-205
references.pmid: 16574946
references.citation: Ann Surg. 2006 Feb;243(2):154-68
references.pmid: 16432347
references.citation: Scand J Gastroenterol. 2006 Apr;41(4):472-80
references.pmid: 16635917
references.citation: Digestion. 2001;63(2):69-91
references.pmid: 11244246
references.citation: Pancreas. 2008 Mar;36(2):192-6
references.pmid: 18376312
references.citation: Pancreas. 2008 Aug;37(2):170-5
references.pmid: 18665079
references.citation: Pancreas. 2008 Oct;37(3):e74-82
references.pmid: 18815542
references.citation: Pancreas. 2009 Jul;38(5):499-502
references.pmid: 19342981
references.citation: Pancreas. 2008 Oct;37(3):295-301
references.pmid: 18815552
references.citation: Crit Care Med. 1996 Jan;24(1):163-72
references.pmid: 8565523
references.citation: Curr Opin Crit Care. 2007 Aug;13(4):416-20
references.pmid: 17599012
references.citation: J Hepatobiliary Pancreat Surg. 2002;9(4):401-10
references.pmid: 12483260
references.citation: J Zhejiang Univ Sci B. 2009 Jul;10(7):493-8
references.pmid: 19585666
references.citation: Chest. 2003 Sep;124(3):1103-15
references.pmid: 12970043
references.citation: Pancreatology. 2003;3(2):93-101
references.pmid: 12774801
references.citation: Ann Surg. 2000 Nov;232(5):619-26
references.pmid: 11066131
references.citation: Arch Surg. 1993 May;128(5):586-90
references.pmid: 8489394
references.citation: Pancreas. 2006 Aug;33(2):174-83
references.pmid: 16868484
references.citation: Hepatogastroenterology. 2005 Jul-Aug;52(64):990-4
references.pmid: 16001614