The Changes Of Lymphocyte Subsets In Peripheral Blood Of Patients With Acute Pancreatitis And It's Mechanism

Objective:To investigate the changes of lymphocyte subsets in peripheral blood of patients with acute pancreatitis(AP),and discuss the possible mechanism of the changes.Methods:73 patients with AP were selected as case group,including 25 cases with mild acute pancreatitis(MAP),25 cases with moderately severe acute pancreatitis(MSAP)and 23cases with severe acute pancreatitis(SAP).25 cases of healthy subjects were selected as the control group.Flow cytology was used to analyze T lymphocyte subsets,CD4~+/CD8~+ratio,CD19~+B lymphocyte expression rate,and lymphocyte autophagy and apoptosis in peripheral blood of patients with AP.Levels of IL-6,IL-10,autophagy gene LC3 and apoptosis gene caspase-3 in peripheral blood of patients with AP were determined by enzyme-linked immunosorbent assay(ELISA).Results:(1)The CD3~+T lymphocyte ratio,CD4~+T lymphocyte ratio and CD19~+B lymphocyte ratio of the SAP group and the MSAP group were all lower than those of the control group and the MAP group(P<0.05),and in the SAP group the above lymphocyte subsets were lower than that of the MSAP group(P<0.05).There was no significant difference between MAP group and the control group(P>0.05).The ratio of CD4~+/CD8~+in each AP group was lower than that in the control group(P<0.05),and was lower in the SAP group than that in MSAP group and MAP group(P<0.05).The ratio of CD4~+/CD8~+also lower in MSAP group than that in the MAP group(P<0.05).(2)The level of serum IL-6 in each AP group was higher than that in the control group(P<0.05),and in the SAP group it was higher than that in the MSAP and MAP groups(P<0.05).In MSAP group it was higher than that in MAP group(P<0.05).(3)The level of serum IL-10 in each AP group was higher than that in the control group,and in the SAP group it was lower than that in MSAP and MAP groups(P<0.05),In MSAP group it was lower than that in MAP group(P<0.05).(4)The levels of LC3?Caspase-3 and the rate of lymphocyte autophagy and apoptosis in peripheral blood of the SAP group were higher than those in the control group?the MAP and MSAP groups(P<0.05),in the MSAP group it were higher than those in the MAP and control groups(P<0.05),but in MAP group it were slightly higher than the control group(P>0.05).(5)Levels of IL-6 and IL-10 in serum of MSAP and SAP groups were positively correlated with the level of LC3 and Caspase-3(P<0.05).As IL-6 and IL-10 levels increased,LC3 and Caspase-3 levels increased.(6)Levels of LC3 and Caspase-3 in serum were positively correlated with autophagy rate and apoptotic rate in MSAP and SAP groups(P<0.05);The levels of LC3 and Caspase-3 were negatively correlated with CD4~+T lymphocyte ratio,CD4~+/CD8~+ratio and CD19~+B lymphocyte ratio(P<0.05).With the increase of LC3 and Caspase-3 levels,the lymphocyte autophagy rate and apoptosis rate increased,while the ratio of CD4~+T lymphocytes,CD4~+/CD8~+ratio and CD19~+B lymphocytes decreased.Conclusion:(1)CD3~+T lymphocyte ratio,CD4~+T lymphocyte ratio,CD4~+/CD8~+ratio,and CD19~+B lymphocyte ratio in peripheral blood of AP patients decreased,especially in patients with SAP,and the immune function is impaired.(2)Levels of IL6 and IL10 in peripheral blood increased,leading to the increasing expression levels of LC3?Caspase-3 and lymphocytes autophagy?apoptosis,which may be an important reason for the change of lymphocyte subsets in patients with AP.