Research progress of immune response in infection associated with severe acute pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SU Yingru , HONG Yupu , ZHOU Yu ,  WANG Weixing

Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, P. R. China;

Corresponding author：

WANG Weixing, Email: sate.llite@163.com

Keywords：

severe acute pancreatitis; infection; immunosuppression; prognosis

DOI：

10.7507/1007-9424.201810021

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize progress of immune response in severe acute pancreatitis (SAP) and to provide a basis for appropriate immunotheraphy.Method The relevant literatures about the effect of immune response in the SAP with infectious complications in recent years were reviewed.Results The inflammatory cascade reaction occurred in the early stage of SAP. Subsequently, the compensatory anti-inflammatory response syndrome (CARS) arised and immune response of the organism was suppressed. At this stage, the rate of infection was higher than before.Conclusions CARS is one of major reasons in SAP with infectious complications. At present, fluid infusion, fasting, parenteral nutrition and like are major therapies in SAP. If corresponding immunotherapy could be carried out according to immune mechanism of SAP infection, that is, early appropriate immunosuppressive therapy and dynamic monitoring of body’s immune system state should be performed, when it is found that immunosuppression is present, appropriate immunostimulus therapy will be possible to reduce mortality of SAP and improve its prognosis.

Citation： SU Yingru, HONG Yupu, ZHOU Yu, WANG Weixing. Research progress of immune response in infection associated with severe acute pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 488-492. doi: 10.7507/1007-9424.201810021 Copy

1.	杨尹默, 陈国卫, 张太平. 重症急性胰腺炎合并感染的治疗策略. 中国实用外科杂志, 2011, 31(9): 880-882.
2.	Schmidt AI, Kühlbrey C, Lauch R, et al. The predominance of a naive T helper cell subset in the immune response of experimental acute pancreatitis. Pancreatology, 2017, 17(2): 209-218.
3.	Pan T, Zhou T, Li L, et al. Monocyte programmed death ligand-1 expression is an early marker for predicting infectious complications in acute pancreatitis. Crit Care, 2017, 21(1): 186.
4.	Sendler M, Weiss FU, Golchert J, et al. Cathepsin B-mediated activation of trypsinogen in endocytosing macrophages increases severity of pancreatitis in mice. Gastroenterology, 2018, 154(3): 704-718. e10.
5.	Muñoz LE, Leppkes M, Fuchs TA, et al. Missing in action—The meaning of cell death in tissue damage and inflammation. Immunol Rev, 2017, 280(1): 26-40.
6.	Li J, Yang WJ, Huang LM, et al. Immunomodulatory therapies for acute pancreatitis. World J Gastroenterol, 2014, 20(45): 16935-16947.
7.	Horiguchi H, Loftus TJ, Hawkins RB, et al. Innate immunity in the persistent inflammation, immunosuppression, and catabolism syndrome and its implications for therapy. Front Immunol, 2018, 9: 595.
8.	Singh VK, Wu BU, Bollen TL, et al. Early systemic inflammatory response syndrome is associated with severe acute pancreatitis. Clin Gastroenterol Hepatol, 2009, 7(11): 1247-1251.
9.	张大鹏, 崔乃强. 重症急性胰腺炎自然病程的临床研究. 中国普外基础与临床杂志, 2015, 22(1): 18-23.
10.	Qin Y, Pinhu L, You Y, et al. The role of Fas expression on the occurrence of immunosuppression in severe acute pancreatitis. Dig Dis Sci, 2013, 58(11): 3300-3307.
11.	Manczinger M, Kemény L. Peptide presentation by HLA-DQ molecules is associated with the development of immune tolerance. PeerJ, 2018, 6: e5118.
12.	Monneret G, Venet F. Monocyte HLA-DR in sepsis: shall we stop following the flow? Crit Care, 2014, 18(1): 102.
13.	Gainaru G, Papadopoulos A, Tsangaris I, et al. Increases in inflammatory and CD14^dim/CD16^pos/CD45^pos patrolling monocytes in sepsis: correlation with final outcome. Crit Care, 2018, 22(1): 56.
14.	Papadopoulos P, Pistiki A, Theodorakopoulou M, et al. Immunoparalysis: Clinical and immunological associations in SIRS and severe sepsis patients. Cytokine, 2017, 92: 83-92.
15.	Schepers NJ, Bakker OJ, Besselink MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut, 2018 Jun 27. pii: gutjnl-2017-314657. doi: 10.1136/gutjnl-2017-314657.
16.	杨珠莹, 谢齐贵, 陈湛蕾, 等. 血清 CRP 与 PCT 及脂肪酶对重症急性胰腺炎患者发生感染性胰腺坏死的预测. 中华医院感染学杂志, 2018, 28(11): 1693-1696.
17.	Lin ZQ, Guo J, Xia Q, et al. Human leukocyte antigen-DR expression on peripheral monocytes may be an early marker for secondary infection in severe acute pancreatitis. Hepato-gastroenterology, 2013, 60(128): 1896-1902.
18.	Cajander S, Bäckman A, Tina E, et al. Preliminary results in quantitation of HLA-DRA by real-time PCR: a promising approach to identify immunosuppression in sepsis. Crit Care, 2013, 17(5): R223.
19.	Cajander S, Rasmussen G, Tina E, et al. Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. PLoS One, 2018, 13(2): e0192883.
20.	Shao R, Fang Y, Yu H, et al. Monocyte programmed death ligand-1 expression after 3-4 days of sepsis is associated with risk stratification and mortality in septic patients: a prospective cohort study. Crit Care, 2016, 20(1): 124.
21.	Ho YP, Sheen IS, Chiu CT, et al. A strong association between down-regulation of HLA-DR expression and the late mortality in patients with severe acute pancreatitis. Am J Gastroenterol, 2006, 101(5): 1117-1124.
22.	Braun NA, Celada LJ, Herazo-Maya JD, et al. Blockade of the programmed death-1 pathway restores sarcoidosis CD4⁺ T-cell proliferative capacity. Am J Respir Crit Care Med, 2014, 190(5): 560-571.
23.	Chang K, Svabek C, Vazquez-Guillamet C, et al. Targeting the programmed cell death 1: programmed cell death ligand 1 pathway reverses T cell exhaustion in patients with sepsis. Crit Care, 2014, 18(1): R3.
24.	Kolber W, Dumnicka P, Maraj M, et al. Does the automatic measurement of interleukin 6 allow for prediction of complications during the first 48 h of acute pancreatitis? Int J Mol Sci, 2018, 19(6): pii: E1820.
25.	Sternby H, Hartman H, Johansen D, et al. IL-6 and CRP are superior in early differentiation between mild and non-mild acute pancreatitis. Pancreatology, 2017, 17(4): 550-554.
26.	Jain S, Midha S, Mahapatra SJ, et al. Interleukin-6 significantly improves predictive value of systemic inflammatory response syndrome for predicting severe acute pancreatitis. Pancreatology, 2018 May 14. pii: S1424-3903(18)30086-3. doi: 10.1016/j.pan. 2018.05.002.
27.	Hoque R, Farooq A, Ghani A, et al. Lactate reduces liver and pancreatic injury in Toll-like receptor-and inflammasome-mediated inflammation via GPR81-mediated suppression of innate immunity. Gastroenterology, 2014, 146(7): 1763-1774.
28.	Pan LL, Deng YY, Wang R, et al. Lactose induces phenotypic and functional changes of neutrophils and macrophages to alleviate acute pancreatitis in mice. Front Immunol, 2018, 9: 751.
29.	Wei Z, Li P, Yao Y, et al. Alpha-lactose reverses liver injury via blockade of Tim-3-mediated CD8 apoptosis in sepsis. Clin Immunol, 2018, 192: 78-84.
30.	Yang N, Ke L, Tong Z, et al. The effect of thymosin α1 for prevention of infection in patients with severe acute pancreatitis. Expert Opin Biol Ther, 2018, 18(sup1): 53-60.
31.	Wang F, Yu T, Zheng H, et al. Thymosin alpha1-Fc modulates the immune system and down-regulates the progression of melanoma and breast cancer with a prolonged half-life. Sci Rep, 2018, 8(1): 12351.
32.	杨天文, 唐泽, 胡永强, 等. 小剂量糖皮质激素能有效调节急性胰腺炎患者的免疫功能. 基因组学与应用生物学, 2018, 37(7): 3075-3079.
33.	Ren C, Li XH, Wang SB, et al. Activation of central alpha 7 nicotinic acetylcholine receptor reverses suppressed immune function of t lymphocytes and protects against sepsis lethality. Int J Biol Sci, 2018, 14(7): 748-759.
34.	Ye C, Wang R, Wang M, et al. Leptin alleviates intestinal mucosal barrier injury and inflammation in obese mice with acute pancreatitis. Int J Obes (Lond), 2018, 42(8): 1471-1479.
35.	He Y, Wu C, Li J, et al. Inulin-type fructans modulates pancreatic-gut innate immune responses and gut barrier integrity during experimental acute pancreatitis in a chain length-dependent manner. Front Immunol, 2017, 8: 1209.
36.	郭阿茹, 马莉, 李杜鹏, 等. 大黄对脓毒症相关大鼠脑功能障碍的作用机制研究. 中国急救医学, 2017, 37(10): 878-883.
37.	Xiong Y, Chen L, Fan L, et al. Free total rhubarb anthraquinones protect intestinal injury via regulation of the intestinal immune response in a rat model of severe acute pancreatitis. Front Pharmacol, 2018, 9: 75.
38.	范方毅, 邓锐, 苏毅. CD43⁺自体干细胞移植联合 DC-CIK 细胞免疫治疗复发难治性淋巴瘤疗效观察. 解放军医药杂志, 2017, 29(3): 15-17.
39.	Ahmed SM, Morsi M, Ghoneim NI, et al. Mesenchymal stromal cell therapy for pancreatitis: a systematic review. Oxid Med Cell Longev, 2018, 2018: 3250864.

1. 杨尹默, 陈国卫, 张太平. 重症急性胰腺炎合并感染的治疗策略. 中国实用外科杂志, 2011, 31(9): 880-882.
2. Schmidt AI, Kühlbrey C, Lauch R, et al. The predominance of a naive T helper cell subset in the immune response of experimental acute pancreatitis. Pancreatology, 2017, 17(2): 209-218.
3. Pan T, Zhou T, Li L, et al. Monocyte programmed death ligand-1 expression is an early marker for predicting infectious complications in acute pancreatitis. Crit Care, 2017, 21(1): 186.
4. Sendler M, Weiss FU, Golchert J, et al. Cathepsin B-mediated activation of trypsinogen in endocytosing macrophages increases severity of pancreatitis in mice. Gastroenterology, 2018, 154(3): 704-718. e10.
5. Muñoz LE, Leppkes M, Fuchs TA, et al. Missing in action—The meaning of cell death in tissue damage and inflammation. Immunol Rev, 2017, 280(1): 26-40.
6. Li J, Yang WJ, Huang LM, et al. Immunomodulatory therapies for acute pancreatitis. World J Gastroenterol, 2014, 20(45): 16935-16947.
7. Horiguchi H, Loftus TJ, Hawkins RB, et al. Innate immunity in the persistent inflammation, immunosuppression, and catabolism syndrome and its implications for therapy. Front Immunol, 2018, 9: 595.
8. Singh VK, Wu BU, Bollen TL, et al. Early systemic inflammatory response syndrome is associated with severe acute pancreatitis. Clin Gastroenterol Hepatol, 2009, 7(11): 1247-1251.
9. 张大鹏, 崔乃强. 重症急性胰腺炎自然病程的临床研究. 中国普外基础与临床杂志, 2015, 22(1): 18-23.
10. Qin Y, Pinhu L, You Y, et al. The role of Fas expression on the occurrence of immunosuppression in severe acute pancreatitis. Dig Dis Sci, 2013, 58(11): 3300-3307.
11. Manczinger M, Kemény L. Peptide presentation by HLA-DQ molecules is associated with the development of immune tolerance. PeerJ, 2018, 6: e5118.
12. Monneret G, Venet F. Monocyte HLA-DR in sepsis: shall we stop following the flow? Crit Care, 2014, 18(1): 102.
13. Gainaru G, Papadopoulos A, Tsangaris I, et al. Increases in inflammatory and CD14^dim/CD16^pos/CD45^pos patrolling monocytes in sepsis: correlation with final outcome. Crit Care, 2018, 22(1): 56.
14. Papadopoulos P, Pistiki A, Theodorakopoulou M, et al. Immunoparalysis: Clinical and immunological associations in SIRS and severe sepsis patients. Cytokine, 2017, 92: 83-92.
15. Schepers NJ, Bakker OJ, Besselink MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut, 2018 Jun 27. pii: gutjnl-2017-314657. doi: 10.1136/gutjnl-2017-314657.
16. 杨珠莹, 谢齐贵, 陈湛蕾, 等. 血清 CRP 与 PCT 及脂肪酶对重症急性胰腺炎患者发生感染性胰腺坏死的预测. 中华医院感染学杂志, 2018, 28(11): 1693-1696.
17. Lin ZQ, Guo J, Xia Q, et al. Human leukocyte antigen-DR expression on peripheral monocytes may be an early marker for secondary infection in severe acute pancreatitis. Hepato-gastroenterology, 2013, 60(128): 1896-1902.
18. Cajander S, Bäckman A, Tina E, et al. Preliminary results in quantitation of HLA-DRA by real-time PCR: a promising approach to identify immunosuppression in sepsis. Crit Care, 2013, 17(5): R223.
19. Cajander S, Rasmussen G, Tina E, et al. Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. PLoS One, 2018, 13(2): e0192883.
20. Shao R, Fang Y, Yu H, et al. Monocyte programmed death ligand-1 expression after 3-4 days of sepsis is associated with risk stratification and mortality in septic patients: a prospective cohort study. Crit Care, 2016, 20(1): 124.
21. Ho YP, Sheen IS, Chiu CT, et al. A strong association between down-regulation of HLA-DR expression and the late mortality in patients with severe acute pancreatitis. Am J Gastroenterol, 2006, 101(5): 1117-1124.
22. Braun NA, Celada LJ, Herazo-Maya JD, et al. Blockade of the programmed death-1 pathway restores sarcoidosis CD4⁺ T-cell proliferative capacity. Am J Respir Crit Care Med, 2014, 190(5): 560-571.
23. Chang K, Svabek C, Vazquez-Guillamet C, et al. Targeting the programmed cell death 1: programmed cell death ligand 1 pathway reverses T cell exhaustion in patients with sepsis. Crit Care, 2014, 18(1): R3.
24. Kolber W, Dumnicka P, Maraj M, et al. Does the automatic measurement of interleukin 6 allow for prediction of complications during the first 48 h of acute pancreatitis? Int J Mol Sci, 2018, 19(6): pii: E1820.
25. Sternby H, Hartman H, Johansen D, et al. IL-6 and CRP are superior in early differentiation between mild and non-mild acute pancreatitis. Pancreatology, 2017, 17(4): 550-554.
26. Jain S, Midha S, Mahapatra SJ, et al. Interleukin-6 significantly improves predictive value of systemic inflammatory response syndrome for predicting severe acute pancreatitis. Pancreatology, 2018 May 14. pii: S1424-3903(18)30086-3. doi: 10.1016/j.pan. 2018.05.002.
27. Hoque R, Farooq A, Ghani A, et al. Lactate reduces liver and pancreatic injury in Toll-like receptor-and inflammasome-mediated inflammation via GPR81-mediated suppression of innate immunity. Gastroenterology, 2014, 146(7): 1763-1774.
28. Pan LL, Deng YY, Wang R, et al. Lactose induces phenotypic and functional changes of neutrophils and macrophages to alleviate acute pancreatitis in mice. Front Immunol, 2018, 9: 751.
29. Wei Z, Li P, Yao Y, et al. Alpha-lactose reverses liver injury via blockade of Tim-3-mediated CD8 apoptosis in sepsis. Clin Immunol, 2018, 192: 78-84.
30. Yang N, Ke L, Tong Z, et al. The effect of thymosin α1 for prevention of infection in patients with severe acute pancreatitis. Expert Opin Biol Ther, 2018, 18(sup1): 53-60.
31. Wang F, Yu T, Zheng H, et al. Thymosin alpha1-Fc modulates the immune system and down-regulates the progression of melanoma and breast cancer with a prolonged half-life. Sci Rep, 2018, 8(1): 12351.
32. 杨天文, 唐泽, 胡永强, 等. 小剂量糖皮质激素能有效调节急性胰腺炎患者的免疫功能. 基因组学与应用生物学, 2018, 37(7): 3075-3079.
33. Ren C, Li XH, Wang SB, et al. Activation of central alpha 7 nicotinic acetylcholine receptor reverses suppressed immune function of t lymphocytes and protects against sepsis lethality. Int J Biol Sci, 2018, 14(7): 748-759.
34. Ye C, Wang R, Wang M, et al. Leptin alleviates intestinal mucosal barrier injury and inflammation in obese mice with acute pancreatitis. Int J Obes (Lond), 2018, 42(8): 1471-1479.
35. He Y, Wu C, Li J, et al. Inulin-type fructans modulates pancreatic-gut innate immune responses and gut barrier integrity during experimental acute pancreatitis in a chain length-dependent manner. Front Immunol, 2017, 8: 1209.
36. 郭阿茹, 马莉, 李杜鹏, 等. 大黄对脓毒症相关大鼠脑功能障碍的作用机制研究. 中国急救医学, 2017, 37(10): 878-883.
37. Xiong Y, Chen L, Fan L, et al. Free total rhubarb anthraquinones protect intestinal injury via regulation of the intestinal immune response in a rat model of severe acute pancreatitis. Front Pharmacol, 2018, 9: 75.
38. 范方毅, 邓锐, 苏毅. CD43⁺自体干细胞移植联合 DC-CIK 细胞免疫治疗复发难治性淋巴瘤疗效观察. 解放军医药杂志, 2017, 29(3): 15-17.
39. Ahmed SM, Morsi M, Ghoneim NI, et al. Mesenchymal stromal cell therapy for pancreatitis: a systematic review. Oxid Med Cell Longev, 2018, 2018: 3250864.

Previous Article
Research progress of radiomics in colorectal cancer
Next Article
Research progress of farnesoid X receptor in regulation of hepatocellular carcinoma

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of immune response in infection associated with severe acute pancreatitis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content