急性胰腺炎患者外周血CD14^+CD16^+单核细胞表达B7-H2的临床意义

背景急性胰腺炎(acute pancreatitis,AP)是常见的急腹症,不同类型预后不同.AP的免疫应答和失衡免疫与其严重程度有关,炎症因子和相关免疫细胞在AP发病机制中至关重要,因而寻找炎症细胞和新炎症免疫因子对精准治疗AP具有重要意义.目的探讨AP患者外周血CD14^+CD16^+单核细胞表达B7-H2的临床意义.方法A P患者63例轻度A P(m i l dA P,M A P)25例、中度AP(moderately severe AP,MSAP)20例、重度AP(severe AP,SAP)18例],对照组为健康体检者20例,采用流式细胞仪检测CD14^+CD16^+细胞亚群上B7-H2表达情况,评价其与胰腺炎严重程度关联性及临床意义.结果AP患者发病24hCD14^+CD16^+细胞B7-H2出现异常高表达,显著高于健康对照组(t=11.10,P<0.001);A P各组B 7-H 2在C D 14^+C D 16^+细胞膜上表达明显高于CD14^+C D16^-细胞膜上表达(P<0.01);SAP组CD14^+C D 16^+和CD14^+C D 16^-细胞B7-H2表达(373.30±89.72和78.62±13.05)最高,M S A P组(279.55±76.95/44.92±12.44)其次,均高于M A P组(181.15±35.75/23.32±4.28),各组两两比较差异有显著性(P<0.01);MAP组、MSAP组发病24 h、48 h、72hCD14^+CD16^+和CD14^+CD16^-单核细胞膜B7-H2动态表达差异无显著性(P>0.05),然而,SAP组无论C D14^+C D16^+还是CD14^+C D16^-细胞膜B7-H2表达24h、48h、72h均呈明显上升趋势,差异有显著性(P<0.05).结论CD14^+CD16^+和CD14^+CD16^-单核细胞膜B7-H2在AP患者体内高表达,与AP严重程度密切相关,且SAP呈动态升高变化;同时B7-H2在AP患者CD14^+CD16^+单核细胞膜表达较CD14^+CD16^-单核细胞明显升高,为进一步认识AP免疫应答和失衡提供了新的线索,为AP精准靶向治疗提供参考.

Clinical significance of B7-H2 expression in peripheral blood CD14^+CD16^+ monocytes in patients with acute pancreatitis

BACKGROUND Acute pancreatitis(AP) is a common acute abdominal disease,and different types of AP have a different prognosis.The immune response and imbalanced immunity in AP patients are related to its severity.Inflammatory factors and related immune cells are of great importance in the pathogenesis of AP.Therefore,finding inflammatory cells and new inflammatory immune factors is of great significance for accurate treatment of AP.AIM To explore the clinical significance of CD14^+CD16^+monocytes expressing B7-H2 in peripheral blood of patients with AP.METHODS A total of 63 patients with AP were enrolled in the study group,including 25 mild AP(MAP) cases,20 moderately severe AP(MSAP) cases,and 18 severe AP(SAP) cases.Twenty healthy subjects were included as a control group.Flow cytometry was used for detection of B7-H2 expression on CD14^+CD16^+cell subsets to evaluate its relevance to the severity of pancreatitis and clinical significance.RESUL TS At 24 h after disease onset in patients with AP,CD14^+CD16^+cells expressing B7-H2 experienced abnormally high expression,which was significantly higher than that of the control group(t=11.10,P <0.001).B7-H2 expression on CD14^+CD16^+ cell membrane in each group of AP patients was significantly higher than that on CD14^+CD16^-cell membrane(P <0.01);B7-H2 expression on CD14^+CD16^+and CD14^+CD16^-cells(373.30±89.72 and 78.62±13.05) in the SAP group was the highest followed by that in the MSAP group(279.55±76.95 and 44.92±12.44) and the MAP group(181.15±35.75 and 23.32±4.28),and the difference between any two of the three groups was significant(P <0.01).At 24 h,48 h,and 72 h after disease onset in the MAP group and MSAP group,there was no significant difference in B7-H2 expression on CD14^+ CD16^+ and CD14^+ CD16^-monocyte membrane(P> 0.05).However,B7-H2 expression on CD7^+ CD16^+ or CD14^+ CD16^-cell membrane in the SAP group at 24 h,48 h,and 72 h showed a clear upward trend,and the difference was significant(P <0.05).CONCLUSION B7-H2 is highly expressed on CD14^+ CD16^+ and CD14^+CD16^-monocyte membrane in patients with AP,which is closely related to the severity of AP.B7-H2 expression on CD14^+CD16^+monocyte membrane in patients with AP is significantly increased compared with that on CD14^+CD16^-monocytes,providing new clues for further recognition of immune response and imbalance in AP and for accurate targeted therapy of AP.