Expanded CD14hi CD16- Immunosuppressive Monocytes Predict Disease Severity in Patients with Acute Pancreatitis
Expanded CD14hi CD16- Immunosuppressive Monocytes Predict Disease Severity in Patients with Acute Pancreatitis
复制标题
扩展的 CD14(hi) CD16(-) 免疫抑制单核细胞可预测急性胰腺炎患者的疾病严重程度
DOI：
10.4049/jimmunol.1801194
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发表时间：
2019-05-01
影响因子：
4.4
通讯作者：
Xue, Jing
中科院分区：
文献类型：
--
作者：
Zhang, Ruling;Shi, Juanjuan;Xue, Jing
轻型急性胰腺炎（AP）是一种自限性疾病，而重型AP由于全身炎症反应增强和多器官功能衰竭而死亡率高。在AP的实验模型中，单核细胞的浸润和单核细胞衍生的巨噬细胞的活化在很大程度上决定了疾病的严重程度。我们以前的研究表明，在AR的早期阶段，CD 11b（+）Ly-6C（hi）炎性单核细胞从骨髓动员到外周血和炎症胰腺中。50名AP患者和9名年龄和性别匹配的健康志愿者参加了这项研究。与健康志愿者相比，AP患者发病48 h内CD 14（hi）CD 16（-）单核细胞比例和骨髓相关细胞因子/趋化因子水平均升高，尤其是病程较重的患者。此外，单核细胞比例增加与HLA-DR表达减少和T细胞计数减少相关。值得注意的是，在中重度AP和重度AR之间，循环CD 14（hi）CD 16（-）单核细胞及其HLA-DR表达以及CD 4（+）T细胞的动态变化明显不同。受试者操作特征分析显示，CD 14（hi）CD 16（-）单核细胞比例与其HLA-DR水平预测AR严重程度的准确性更高。综合分析，CD 14（hi）、CD 16（-）单核细胞比值及其HLA-DR水平可能有助于AP患者入院时病情严重程度的预测和恢复期临床状态的监测。
Mild acute pancreatitis (AP) is a self-limiting disease, whereas severe AP has high mortality because of enhanced systemic inflammation and multiple organ failure. In experimental models of AP, infiltration of monocytes and activation of monocyte-derived macrophages largely determine the severity of the disease. Our previous studies have shown that CD11b(+)Ly-6C(hi) inflammatory monocytes were mobilized from bone marrow into peripheral blood and inflamed pancreas during the early stage of AR However, the phenotype and characteristics of circulating monocytes in patients with AP are not well defined. Fifty patients with AP and nine age- and sex-matched healthy volunteers were enrolled in this study. Compared with those of healthy volunteers, the proportion of CD14(hi)CD16(-) monocytes and the level of myeloid-related cytokines/chemokines were increased in AP patients within 48 h after disease onset, especially in patients with a severe disease course. Moreover, the increased monocyte proportions were associated with decreased HLA-DR expression and a reduced T cell count. Notably, dynamic changes in circulating CD14(hi)CD16(-) monocytes and their HLA-DR expression, as well as in CD4(+) T cells, were obviously different between moderate severe AP and severe AR Last, area under the receiver operating characteristic analysis showed that the combination of CD14(hi)CD16(-) monocyte proportions with their HLA-DR level had higher accuracy for predicting the severity of AR Taken together, the ratio of CD14(hi)CD16(-) monocytes and their HLA-DR level might assist in predicting the severity of disease in AP patients at admission and in monitoring patients' clinical status during recovery.