The nature of changes in individual immunological parameters in patients with acute pancreatitis
Keywords:acute pancreatitis, IgG subclasses, immunosuppression
AbstractBackground. 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.
Мальцев Д.В. Дефіцит субкласів IgG: клініка, діагностика, лікування // Клінічна імунологія, алергологія, інфектологія. — 2015. — № 5–6(84–85). — С. 4-16.
Мальцев Д.В. Малі імунодефіцитні хвороби. — К.: Центр учбової літератури, 2015. — 460 с.
Bonilla F.A., Oettgen H.C. Adaptive immunity // J. Allergy Clin. Immunol. — 2010. — Vol. 125(2, Suppl. 2). — Р. 33-40.
Collins A.M., Jackson K.J.L. A temporal model of human IgE and IgG antibody function // Frontiers in Immunology. — 2013. — Vol. 4. — P. 235.
Di P., Sun J., Zhu J. et al. Serum IgG subtypes
features and differential diagnosis of autoimmune pancreatitis patients // Zhonghua Yi Xue Za Zhi. — 2016. — Vol. 96(8). — P. 646-649.
Hallay J., Kovács G., Szatmári K. et al. Early jejunal nutrition and changes in the immunological parameters of patients with acute pancreatitis // Hepatogastroenterology. — 2001. — Vol. 48(41). — P. 1488-1492.
Klimenko V.N., Isaĭchikov I.I., Gaĭdash O.V., Beliaeva S.I. Immunity disorders in an acute destructive pancreatitis and methods of their correction // Klin. Khir. — 2005. — Vol. 2. — P. 24-30.
Schulz H.U., Schmidt D., Kunz D. et al. Cellular and humoral functions in acute pancreatitis // Wien. Med. Wochenschr. — 1997. — Vol. 147(1). — P. 10-13.
Ueda T., Takeyama Y., Yasuda T. et al. Immunosuppression in patients with severe acute pancreatitis // J. Gastroenterol. — 2006. — Vol. 41(8). — P. 779-784.
Zaporozhchenko B.S. Changes in lipid metabolism and indicators of immunological reactivity in programmed relaparotomy in acute pancreatitis // Klin. Khir. — 1998. — Vol. 2. — P. 14-15.
Copyright (c) 2018 UKRAINIAN JOURNAL OF SURGERY
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.