Changes And The Significance Of Th17/Treg Immune Imbalance In Secondary Systemic Infection In Patients With Severe Acute Pancreatitis

Objective\r\nTo investigate changes and the significance of Th17/Treg immune imbalance in secondary systemic infection in patients with severeacute pancreatitis.\r\n\r\n\r\nMethods\r\nWe selected 21 patients with severe acute pancreatitis and secondary systemic infection (infection group), 25 patients with severe alone (non-infection group), 20 healthy cases undergoing annual health check-up (control group) in this study. The expression levels of Th17/Treg cells and related cytokines were compared between groups.\r\n\r\n\r\nResults\r\nThere were significant differences in mortality rate and duration of ICU stay between infection group and non-infection group 〔23.8% vs. 4.0%, (11.3±3.4) d vs. (7.5±2.8) d, χ2=3.949, t=2.890, P=0.047 and 0.045〕. The percentages of Th17 cell and Treg cell, Th17/Treg ratio, mRNA expressions of IL-6, IL-17, IL-23, TGF-β and orphan receptor -γt were higher in infection and non-infection groups than in control group 〔(26.4±1.2)%, (12.8±0.9)% vs. (3.1±0.8) %; (6.7±1.6)%, (4.2±1.3)% vs. (1.3±0.4)%; (4.3±1.0)%, (3.2±1.1)% vs. (2.4±0.9)%; (7.1±0.8)ng/L, (5.3±0.7)ng/L vs. (0.2±0.1)ng/L; (22.9±2.4)ng/L, (15.6±2.8)ng/L vs. (10.3±1.5)ng/L; (15.7±2.1)ng/L, (10.2±1.5)ng/L vs. (8.3±1.4)ng/L; (23.6±2.2)ng/L, (16.3±1.7)ng/L vs. (11.6±1.1)ng/L; (0.052±0.014), (0.035±0.010) vs. (0.004±0.001); F=15.761, 55.745, 9.437, 102.788, 21.038, 16.239, 36.957, 23.924, respectively, P=0.555, 0.000, 0.014, 0.000, 0.002, 0.004, 0.000, 0.000〕. The mRNA expressions of IL-10 and Foxp3-T were lower in infection and non-infection groups than in control group 〔(6.4±1.1)ng/L, (10.5±2.1)ng/L vs. (15.4±2.0)ng/L; (0.005±0.001), (0.020±0.007) vs. (0.032±0.009), F=18.995 and 20.608, P=0.003 and 0.002〕.\r\n\r\n\r\nConclusions\r\nThe secondary infection can aggravate the Th17 / Treg immune imbalance in patients with severe acute pancreatitis, and extend the ICU hospitalization days.\r\n\r\n\r\nKey words: \r\nFancreatitis, necrotizing; Infection; T-lymphocyte subsets; T-lymphocyte, regulatory