Change of Humoral Immunity in Early Stage of Acute Pancreatitis / 胃肠病学

ABSTRACT

Background:Impaired immune function occurs in the early stage of acute pancreatitis (AP). Aims:To explore the changes of serum immunoglobulins in the early stage of AP and their values in predicting the severity of the disease. Methods:A total of 164 AP patients diagnosed within 24 hours of onset from Jan. 2014 to Dec. 2014 at the First Affiliated Hospital of Soochow University were enrolled. The number of patients with mild,moderately severe,and severe AP (MAP, MSAP and SAP)were 103,47 and 14,respectively. Twenty-two healthy subjects were served as controls. Serum samples were collected within 48 hours of onset for detection of IgG,IgA,IgM,κ light chain and λ light chain levels. ROC curve and area under the curve (AUC)were used to assess the performance of these indices for predicting the disease severity. Results:A decline in varying degrees was observed in serum levels of IgA,IgM,κ light chain and λ light chain within 48 hours of onset of AP. The difference was statistically significant in serum IgM between MSAP,SAP groups and MAP group (P＜0.05). ROC curve showed that serum IgM had a moderate accuracy for differentiating MSAP and SAP from MAP (AUC＝0.723,95% CI0.634-0.812);with cut-off value≤1.055 g/L,the sensitivity and specificity were 0.806 and 0.689,respectively. Conclusions:Serum levels of IgA,IgM,κ light chain and λ light chain decrease obviously in the early stage of AP,which suggests humoral immune dysfunction. Serum level of IgM may be used as a predictor for severity of AP in early stage of the disease.