HLA-DR expression in acute pancreatitis

• Published in: The European journal of surgery Vol. 165; no. 10; pp. 947 - 951
• Main Authors: Richter, A., Nebe, T., Wendl, K., Schuster, K., Klaebisch, G., Quintel, M., Lorenz, D., Post, S., Trede, M.
• Format: Journal Article
• Language: English
• Published: UK Taylor & Francis, Ltd 01.10.1999; Taylor & Francis
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; C-Reactive Protein - analysis; Female; Flow Cytometry; Gastroenterology. Liver. Pancreas. Abdomen; HLA-DR Antigens - analysis; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Macrophages - immunology; Male; Medical sciences; Middle Aged; Monocytes - immunology; Other diseases. Semiology; Pancreatitis, Acute Necrotizing - immunology; Pancreatitis, Acute Necrotizing - mortality; Pancreatitis, Acute Necrotizing - surgery; Prognosis; Survival Rate; Human; Prognosis; Monocyte; Pathophysiology; Acute; HLA-DR-System; Pancreatitis; Digestive diseases; Pancreatic disease; Gravity
• ISSN: 1102-4151; 1741-9271
• DOI: 10.1080/110241599750008053

Objective: To investigate the role of the monocyte/macrophage system in acute pancreatitis Design: Prospective clinical study Setting: University clinic, Germany Subject: 37 consecutive patients who presented with acute pancreatitis. Main outcome measure: Correlation between function of monocytes measured by HLA‐DR expression and outcome Results: Patients were divided into three groups according to outcome : those with severe pancreatitis who died (n = 10), those with severe pancreatitis who survived (n = 15), and those with mild pancreatitis who survived (n = 12). There was a clear and significant difference between those with severe and those with mild disease. HLA‐DR expression was initially depressed in both groups, but after the third day of treatment it started to recover significantly in those with mild disease (p < 0.05). The difference was also significant from day 7 onwards between those with severe disease who died and those with severe disease who survived (p < 0.05). Conclusion: Monocyte function as measured by HLA‐DR expression (CD14+DR+) is reduced in patients with acute pancreatitis and does not recover in patients who are going to die (median < 20 relative antigen density units; RU). Copyright © 1999 Taylor and Francis Ltd.