The Role of Fas Expression on the Occurrence of Immunosuppression in Severe Acute Pancreatitis
The Role of Fas Expression on the Occurrence of Immunosuppression in Severe Acute Pancreatitis
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Fas表达在重症急性胰腺炎免疫抑制发生中的作用
DOI：
10.1007/s10620-013-2793-8
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发表时间：
2013-07
影响因子：
3.1
通讯作者：
Z Huang...
中科院分区：
文献类型：
--
作者：
Y Qin;L Pinhu;Y You;S Sooranna;Z Huang...
背景：严重急性胰腺炎（SAP）是一种死亡率高的危险疾病，大多数患者不是死于过度炎症，而是死于免疫抑制和后期多重感染。SAP的免疫抑制机制尚不清楚。目的分析Fas表达在SAP患者免疫抑制发生中的作用。方法48例胰腺炎患者分为SAP组20例（合并脓毒症7例，未合并脓毒症13例）和轻度急性胰腺炎（MAP）组28例。选取28名健康志愿者作为对照。采用qPCR检测外周血Fas mRNA表达和淋巴细胞膜Fas蛋白表达；流式细胞术检测外周血T淋巴细胞亚群及单核细胞人白细胞抗原DR （HLA-DR）的表达。结果与MAP组和对照组相比，SAP组外周血Fas mRNA和淋巴细胞Fas蛋白表达水平显著升高（均p < 0.01）。脓毒症SAP组与未患脓毒症SAP组相比，脓毒症SAP组的脓毒症发生率进一步显著升高（p < 0.01）。SAP组CD4+T细胞比值、CD4+/CD8+比值及单核细胞HLA-DR表达均显著低于MAP组和对照组（均p < 0.01）。SAP脓毒症患者Fas mRNA表达与CD4+ t细胞比值、CD4+/CD8+比值、单核细胞HLA-DR表达呈显著负相关（均p < 0.05）。结论Fas的表达水平与胰腺炎的严重程度和免疫状态有关。Fas过表达可导致免疫抑制和脓毒症的发生。
BackgroundSevere acute pancreatitis (SAP) is a dangerous illness with high mortality where most patients do not die of excessive inflammation, but die of immunosuppression and multiple infections at a later stage. The mechanism of immunosuppression in SAP is unknown.AimThe purpose of this study was to analyze the role of Fas expression on the occurrence of immunosuppression in patients with SAP.MethodsForty-eight patients with pancreatitis were divided into two groups: 20 cases with SAP (7 cases with sepsis, 13 cases without sepsis) and 28 cases with mild acute pancreatitis (MAP). Twenty-eight healthy volunteers were selected as controls. Fas mRNA expression in peripheral blood was detected by qPCR and Fas protein of lymphocyte membranes; T lymphocyte subsets and expression of monocyte Human leukocyte antigen DR (HLA-DR) in peripheral blood were detected by flow cytometry.ResultsCompared with MAP and control groups, expression level of Fas mRNA and lymphocyte Fas protein in peripheral blood were significantly increased in the SAP group (allP< 0.01). There was a further significant increase in the SAP group with sepsis compared to those without sepsis (allP< 0.01). The CD4+T cell ratio, CD4+/CD8+ratio and monocyte HLA-DR expression in the SAP group were decreased significantly compared with MAP and control groups (allP< 0.01). Significant negative relationships were observed between Fas mRNA expression and CD4+T-cell ratio, CD4+/CD8+ratio, and monocyte HLA-DR expression in SAP patients with sepsis (allP< 0.05).ConclusionsThe results suggest that expression level of Fas is related to severity and immune status of pancreatitis. Overexpression of Fas may lead to the occurrence of immunosuppression and sepsis.
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影响因子：
1.3
作者：
J. Kleeff;H. Friess
通讯作者：
J. Kleeff;H. Friess
DOI：
--
发表时间：
1995
期刊：
--
影响因子：
--
作者：
M. Fitzgerald;I. P. Hayward;Anita C. Thomas;Julie H. Campbell;Gordon R. Campbell
通讯作者：
M. Fitzgerald;I. P. Hayward;Anita C. Thomas;Julie H. Campbell;Gordon R. Campbell
影响因子：
8.8
作者：
Brivet, FG;Emilie, D;Galanaud, P
通讯作者：
Galanaud, P
DOI：
10.1016/s0140-6736(89)90381-4
发表时间：
1989-07
期刊：
The Lancet
影响因子：
--
作者：
M. Larvin;M. Mcmahon
通讯作者：
M. Larvin;M. Mcmahon
DOI：
--
发表时间：
1993
期刊：
Annales de chirurgie
影响因子：
--
作者：
E. Bradley
通讯作者：
E. Bradley