Year 2018 Vol. 26 No 6

GENERAL & SPECIAL SURGERY

YU.S. VINNIK, S.S. DUNAEVSKAYA, D.A. ANTUFRIEVA, V.V. DEULINA

INFLUENCE OF THE IMMUNE STATUS AND BLEBBING OF THE LYMPHOCYTES PLASMATIC MEMBRANE ON PERIPANCTREATIC INFILTRATES FORMATION IN SEVERE ACUTE PANCREATITIS

Krasnoyarsk State Medical University named after Prof. V.F.Voino-Yasenetsky, Krasnoyarsk,
The Russian Federation

Objective. To reveal the features of the immune status and blebbing of lymphocytes connected with the course of peripancreatic infiltrates in severe acute pancreatitis.
Methods. 86 patients with severe acute pancreatitis and peripancreatic infiltrates who came to Ia disease phase were studied. In 42 patients complete clearance of infiltrate was observed (the 1st group). 44 patients, in whom pseudocysts and purulent complications developed, made up the 2nd group.
On hospitalization, a cellular link of immunity (CD3+, CD4+, CD8+, CD16+, CD19+, CD25+, CD95+, CD72+, HLA-DR+) was estimated using the method of indirect immunofluorescence, phagocytes activity with flowing cytometry, interleukin-4, interleukin-6, interleukin-10 and tumor necrosis factor alpha with the immunofermental analysis, the membrane state of lymphocytes with phase and contrast microscopy. Presence of infiltrate was defined on the 14th day from the beginning of the disease.
Results. T-lymphocytes, NK-cells and CD25+ had a strong inverse correlation with unfavorable course. There is a strong direct correlation of CD95+ with unfavorable course. The immune regulatory index had a strong inverse correlation with unfavorable course of rS=-0.76, (p<0.001). Interleukin-6 was increased in both groups. There was the correlation of the tumor necrosis factor alpha with unfavorable course of rS=0.69, (p<0.001). Interleukin-10 was increased in the 1st group. In the 1st group the cells in the condition of the initial blebbing exceeded the norm in 2 times, in the 2nd group in 3 times. The terminal blebbing in the 1st group was 4 times higher, in the 2ndgroup in 8 times. Increase in the total blebbing happened due to a terminal blebbing in both groups.
Conclusions. The unfavorable course of peripancreatic infiltrates is followed by lymphopenia, decrease in relative population of T-helpers, NK-cells, CD25+, the increase in CD95+, expressed decrease in the immunoregulatory index, increase in interleukin-6, tumor necrosis factor alpha, increase in indicators of terminal and total blebbing of lymphocytes.

Keywords: pancreatitis, peripancreatic infiltrates, immunity, blebbing, lymphocyte, interleukin
p. 689-696 of the original issue
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Address for correspondence:
660077, The Russian Federation,
Krasnoyarsk, Partizan Zheleznyak Str., 1,
Krasnoyarsk State Medical University
Named after Prof. V.F.Voino-Yasenetsky,
General Surgery Department
Named after Prof. M.I. Gulman,
Tel. office: +963-191-29-70,
e-mail: Vikto-potapenk@yandex.ru,
Svetlana S. Dunaevskaya
Information about the authors:
Vinnik Yurii S., MD, Professor, Head of the General Surgery Department named after Prof. M.I. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russian Federation.
http://orcid.org/0000-0002-8995-2862
Dunaevskaya Svetlana S., MD, Associate Professor of the General Surgery Department named after Prof. M.I. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russian Federation.
http://orcid.org/0000-0003-2820-4737
Antufrieva Daria A., PhD, Assistant of the General Surgery Department named after Prof. M.I. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russian Federation.
http://orcid.org/0000-0003-0190-7336
Deulina Vera V., Full-Time Post-Graduate Student of the General Surgery Department named after Prof. M.I. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russian Federation.
http://orcid.org/0000-0002-7515-0500
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