title: Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis.
abstract: OBJECTIVE
  To observe immune system changes in patients with secondary infection from severe acute pancreatitis (SAP).
  
  
  METHODS
  Seventy-nine patients were recruited. The percentages of CD4+, CD8+, natural killer (NK), HLA-DR+ cells and B lymphocytes, and the CD4+/CD8+ ratio, were determined. In addition, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-4 (IL-4) serum levels were determined on days 1, 7, 14, and 28.
  
  
  RESULTS
  Fifteen patients had a secondary infection. The immune response of the infected group was quite different from the non-infected group, with a higher percentage of CD4+ and HLA-DR+ cells on days 1, 7, 14 and 28, a higher percentage of CD8+ and NK cells on days 14 and 28, a reduced CD4+/CD8+ ratio, and a reduction in B lymphocytes. The cytokine levels in the infected group were different from the non-infected group, with a rise in TNF-α and IL-6 through the first 2 weeks, but dropping at 1 month. IL-10 and IL-4 increased initially, but then dropped over the next 3 weeks.
  
  
  CONCLUSIONS
  An early excessive immune response followed by a subsequent immune deficiency is closely related to secondary SAP infection.
authors.affiliation: Department of Surgery, Hubei Hospital of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, People's Republic of China.
authors.forename: YinFeng
authors.initials: Y
authors.lastname: Shen
authors.forename: Nai-Qiang
authors.initials: NQ
authors.lastname: Cui
mesh_terms: D060085:Coinfection / Q000097:blood / Q000150:complications / Q000276:immunology*; D016207:Cytokines / Q000097:blood; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D018655:Lymphocyte Count; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000276:immunology*
chemical_list: D016207:Cytokines; D006684:HLA-DR Antigens