MONONUCLEAR PHAGOCYTE ACTIVATION AND ACUTE-PANCREATITIS

Severe, acute pancreatitis is commonly associated with a systemic illn ess which may result in multiple organ failure. There is evidence that an aberrant immune response, involving Increased secretion of proinfl ammatory cytokines from activated monocytes and mononuclear phagocytes , is responsible far another systemic illness-septic shack Previous st udies have investigated whether there is a correlation between plasma cytokine levels and severity of pancreatitis. However, these results m ay not reflect mononuclear phagocyte activation. In this paper, monocy tes (collected from patients with severe pancreatitis) were cultured i n vitro and secreted cytokine levels measured after 24 hours by ELISA. Secretion of tumour necrosis factor alpha, interleukin-6 and interleu kin-8 was higher in cells taken from patients who later developed syst emic complications. There was no difference in the secretion of interl eukin-l beta. The mechanism by which mononuclear phagocytes are activa ted in acute pancreatitis, and the role of genetic predisposition, are discussed.