DOI: https://doi.org/10.22141/1997-2938.4.35.2017.118894

The nature of changes in individual immunological parameters in patients with acute pancreatitis

V.I. Desyateryk, M.S. Krykun, D.V. Maltsev, I.I. Solonko

Abstract


Background. The results of a number of controlled clinical studies indicate that the deficiency of classes/subclasses of immunoglobulins (Ig) is a negative predictor of clinical outcome and biomarker of potential response to immunoglobulin as an immunomo­dulatory and anti-inflammatory agent in many human autoimmune diseases, including acute pancreatitis. The purpose was to study the subclass of blood serum IgG in patients with acute pancreatitis in various phases of the pathological process and to evaluate the potential informativeness of the results obtained for clinical practice. Materials and methods. The study group consisted of 30 patients diagnosed with acute pancreatitis, who underwent 3-times measurement of the blood serum concentration of IgG1–4 subclasses: on days 1, 7 and 14 of hospitalization. The control group included 10 people, who did not suffer from acute pancreatitis or other acute inflammatory diseases. Measurement of IgG subclass concentrations in the blood serum was carried out using enzyme-linked immunosorbent assay (Thermo Fisher Scientific Inc., USA). The statistical processing of the obtained data was carried out using structural and comparative analyzes, as well as analysis of variance with the calculation of the Student’s parametric criterion and the index of confidence probability p. Results. The mean serum concentrations of IgG subclasses were lower in patients with acute pancreatitis than in controls, but no significant difference was observed in any of these cases (p > 0.05), which was due to the heterogeneity of the study group in terms of the dynamics of the subclass composition of blood serum immunoglobulins. IgG1 was characterized by a unbalanced content with a high specific gravity of reduced values throughout the observation period with a tendency to predominance of hyperproduction on day 14, whereas the IgG4 concentration was initially low in most cases with a weak tendency to normalize on 14th day. In general, about 60 % of patients had low serum concentrations of IgG classes/subclasses on all or some of the observation days. These patients were considered as potential responders for immunoglobulin. The data obtained are interpreted as a result of the interaction of immunoreactivity, secondary immunosuppression, and peculiarities of the immune status of the patient until the moment of the illness. Conclusions. Determination of the serum concentration of IgG subclasses in patients with acute panreatitis may be useful for (a) determining the phase of the autoimmune reaction underlying the disease, (b) evaluating the intensity of immune inflammation at various stages of the pathological process, and (c) determining the immune status for the diagnosis of humoral immune deficiency, which will allow a more accurate assessment of the severity of the patient’s condition, to choose better the treatment interventions, including immunoglobulin, and to carry out a qualitative prediction of the future course of the disease.

Keywords


acute pancreatitis; IgG subclasses; immunosuppression

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