Changes of Cellular Immunity Indoces in Patients with Acute Biliary Pancreatitis

V.S. Osadets


Introduction. Often acute pancreatitis develops in a dysfunction of the immune system. Even so, perfectly still unclear response characteristics of cell and humoral immunity in the development of this pathology, little studied is the diagnostic and prognostic significance of immunological parameters, which in recent years have become more affordable for the needs of practical medicine.
Materials and methods. In 24 patients with acute biliary pancreatitis we performed immunophenotyping subpopulations of T-and B-lymphocytes using monoclonal antibodies. For immunophenotyping subpopulations of T- and B-lymphocytes using monoclonal antibodies CD3. CD4. CD8. SD24. SD56 (Sigma, USA), IPO-C, IPO-4. IPO-47 (Institute of experimental pathology, oncology and radiobiology named after R.Ye. Kavetsky of National Academy of Sciences of Ukraine).
Results and discussion. We found that the overall differentiation of T-lymphocytes in the patients examined in dynamic treatments ranged from normal values, indicating a normal response of cellular immunity with purulent process in the gall bladder. When patient on admission to hospital level CD3 was not significant increased in comparison with the data of the control group 70.30 ± 8.66 % to 76.23 ± 6.34 %, which, however, could be evidence of activation of cellular immunity. After the elimination of purulent focus on 3rd — 5th day is slightly decreased in the normal range, indicating a shift from humoral immune response type. Along with this, these patients noted the increased percentage of CD8 (T-suppressor) to 38.24 ± 3.48 %, versus 32.14 ± 4.82 % in the control group p < 0.05. The level of CD4 (T-helper) was 35.41 ± 1.12%, which was significantly lower than control group 45.82 ± 6.80 %, p < 0.05. In patients treated for 3rd — 5th day observed increase in CD4. and least pronounced it was in patients admitted to hospital more than 48 hours 42.12 ± 1.76 %, p < 0.05. At the time of discharge from the hospital level of T-helper slowly approaching the performance of the control group. The level of T-suppressor cells on 3rd — 5th day far exceeded the performance of the control group 44.56 ± 3.34 %, p < 0.05 and only at time of discharge from the hospital approached normal values. The level of CD95 was significantly increased during patient on admission to hospital 7.23 ± 1.42 % against the performance of the control group 4.24 ± 1.03 %, p < 0.05. In patients treated with CD95 increased to 12.47 ± 2.08 % and did not reach the performance standards even at the time of discharge from hospital patients 8.12 ± 1.53 %. The most pronounced of these changes were in patients admitted to the hospital four or more days after onset.
Conclusion. Changes of cellular immunity indicate that activation of the immune response in patients with acute biliary pancreatitis develops in cytotoxic T-cell type, and increase the level of T-helper cells in patients treated with evidence of its reorientation on humoral immune response. Along with this, it should be noted that in patients admitted to the hospital in a few days from the onset of these processes were more delayed and had no tendency to normalization.


acute biliary pancreatitis; cellular immunity


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