BEHAVIOR OF SERUM-SOLUBLE INTERLEUKIN-2 RECEPTOR, SOLUBLE CD8 AND SOLUBLE CD4 IN THE EARLY PHASES OF ACUTE-PANCREATITIS

When activated, lymphocytes secrete glycoproteins related to particula r surface proteins, including soluble forms of the interleukin-2 recep tor (sIL-2R) and of the surface proteins CD4 (sCD4) and CD8 (sCD8). We evaluated the release of these glycoproteins in order to assess the a ctivation of the cellular immune system during the course of acute pan creatitis. Thirty-five patients with acute pancreatitis (22 M, 13 F, m ean age 64 years, range 16-97) were studied. The diagnosis was based o n typical abdominal pain associated with a twofold increase of serum l ipase as well as morphological abnormalities compatible with acute pan creatitis seen at computed tomography and/or ultrasonography. The panc reatitis was of biliary origin in 22 patients, due to alcohol abuse in 8, due to pancreas divisum in1, due to type IV hyperlipoproteinemia i n 1 and of unknown origin in 3. Based on clinical outcome, 22 patients had mild pancreatitis, whereas 13 had severe disease. In all patients serum sIL-2R, sCD4 and sCD8 were determined on admission and daily fo r the following 5 days using enzyme immunoassay (EIA) techniques. Seru m concentrations of sIL-2R and sCD8 were significantly higher in acute pancreatitis patients relative to healthy controls during the entire observation period, whereas sCD4 levels were significantly lower in ac ute pancreatitis patients than in the control group from the 2nd to th e 6th day of observation. Serum sIL-2R concentrations were significant ly higher in patients with severe pancreatitis than in those with the mild form of the disease, whereas no differences in serum concentratio ns of sCD8 and sCD4 were found between patients with mild pancreatitis and those with severe disease. No differences in serum levels of sIL- 2R, sCD8 and sCD4 were found between patients with biliary pancreatiti s and those with other etiologic forms of the disease. The results ind icate that in the early phases of acute pancreatitis there is an activ ation of the cellular suppressor-cytotoxic immune system and impaired activity of the CD4 T lymphocytes; furthermore, serum sIL-2R may be he lpful in early assessment of the severity of this disease.