Purpose

This study aimed to assess the significance of immunophenotyping and serum cytokines in predicting the clinical progression of acute biliary pancreatitis (ABP).

Materials and methods

Cytokine levels, T-helper, cytotoxic T, natural killer (NK) cells, monocytes, HLA-DR, and PD-1, as well as PDL-1 immune checkpoints, were measured in ABP patients at the time of diagnosis and compared with results from healthy volunteers. The study also compared leukocyte counts, hematocrit, immunophenotyping results, cytokine statuses, and PD-1, PDL-1 expression between healthy volunteers and ABP subgroups categorized by pancreatitis severity.

Results

The study included 65 ABP patients and 20 healthy volunteers. Significant differences were observed between groups in hematocrit, leukocyte counts, total monocytes, lymphocytes, CD3⁺ total T cells, CD4⁺ Th cells, PD-1 expression on CD4⁺ and CD8⁺ T lymphocytes, HLA-DR expression on CD14⁺ monocytes, NK cells, PD-L1 expression on CD14+ monocytes, classical and intermediate monocytes, as well as levels of IL-6, IL-8, IL-10, IL-18, and IL-33 cytokines. Moderate correlations were found with lymphocyte counts, PD-1⁺CD4⁺ cells, PD-L1⁺CD14⁺ cells, and strong correlations with HLA-DR⁺CD14⁺ cells. Hematocrit, CD3⁺ total T cells, NK cells, CD4⁺PD-1 ⁺ T cells, and CD8⁺PD-1 ⁺ T cells showed independent associations with the severity of ABP. Lymphocyte counts, CD14⁺HLA-DR⁺ cells, CD14⁺PD-L1⁺ cells, CD4⁺PD-1 ⁺ T cells, classical, and intermediate monocytes exhibited the highest Area Under the Curve rates in determining organ failure.

Conclusions

Hematocrit, lymphocyte counts, CD14⁺HLA-DR⁺ cells, CD14⁺PD-L1⁺ cells, and intermediate monocytes emerged as parameters most closely associated with the severity and these parameters could be useful in predicting the severity of ABP.

中文翻译：

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我们能否利用淋巴细胞和单核细胞上的PD-1和PD-L1表达作为急性胆源性胰腺炎预后的预测标志物？

目的

本研究旨在评估免疫表型和血清细胞因子在预测急性胆源性胰腺炎（ABP）临床进展中的意义。

材料和方法

在诊断时测量 ABP 患者的细胞因子水平、T 辅助细胞、细胞毒性 T、自然杀伤 (NK) 细胞、单核细胞、HLA-DR 和 PD-1 以及 PDL-1 免疫检查点，并与健康志愿者的结果。该研究还比较了健康志愿者和按胰腺炎严重程度分类的 ABP 亚组之间的白细胞计数、血细胞比容、免疫表型结果、细胞因子状态以及 PD-1、PDL-1 表达。

结果

该研究包括 65 名 ABP 患者和 20 名健康志愿者。血细胞比容、白细胞计数、单核细胞总数、淋巴细胞、CD3 ⁺总T细胞、CD4 ^{+ Th细胞、CD4 +}和CD8 ⁺ T淋巴细胞上的PD-1表达、CD14 ⁺单核细胞上的HLA-DR表达、组间观察到显着差异。 NK 细胞、CD14+ 单核细胞、经典和中间单核细胞上的 PD-L1 表达，以及 IL-6、IL-8、IL-10、IL-18 和 IL-33 细胞因子的水平。^{与淋巴细胞计数、PD-1 +} CD4 ⁺细胞、PD-L1 ⁺ CD14 ⁺细胞呈中度相关性，与 HLA-DR ⁺ CD14 ⁺细胞呈强相关性。血细胞比容、CD3 ⁺总T细胞、NK细胞、CD4 ⁺ PD-1  ⁺  T细胞和CD8 ⁺ PD-1  ⁺  T细胞与ABP的严重程度独立相关。淋巴细胞计数、CD14 ⁺ HLA-DR ⁺细胞、CD14 ⁺ PD-L1 ⁺细胞、CD4 ⁺ PD-1  ⁺  T细胞、经典单核细胞和中间单核细胞在确定器官衰竭时表现出最高的曲线下面积率。

结论

血细胞比容、淋巴细胞计数、CD14 ⁺ HLA-DR ⁺细胞、CD14 ⁺ PD-L1 ⁺细胞和中间单核细胞成为与严重程度最密切相关的参数，这些参数可用于预测 ABP 的严重程度。