IMMUNE FUNCTION EARLY IN ACUTE-PANCREATITIS

Circulating lymphocyte numbers and activation together with granulocyt e function were measured in 20 patients in the early stages of an atta ck of acute pancreatitis and in 20 healthy controls. Circulating lymph ocytes, T lymphocytes, and CD4 and CD8 T lymphocyte subsets were decre ased in both mild pancreatitis (67-80 per cent of controls) and severe pancreatitis (22-40 per cent of controls). CD4:CD8 ratios were unchan ged and median (interquartile range) interleukin 2 receptor expression was increased from less than 1 per cent in controls to 14(6) per cent in severe pancreatitis, suggesting lymphocyte activation. Median gran ulocyte chemiluminescence was increased to 293 per cent of controls in severe pancreatitis and random motility was reduced to 77 per cent of controls, indicating increased metabolic activity. Complement-mediate d antibody-independent opsonization and chemotaxis toward endotoxin we re normal. Immune function is not reduced early in acute pancreatitis. Granulocyte hyperactivity may be important in the development of mult iple organ failure.