Intracellular cytokines in cells of necrotic tissue from patients with acute pancreatitis

Objective: To determine the alterations in intracellular cytokine responses in necrotic pancreatic tissue obtained on debridement from patients with a cute pancreatitis. Design: Laboratory study. Setting: Teaching hospital, India. Material: Necrotic tissue obtained at necrosectomy from 34 patients with al cohol-induced or biliary pancreatitis (n = 17 in each) and at autopsy from 12 controls. Interventions: Histopathological evaluation; measurement of in tracellular content of the cytokines interleukin (IL)-2, IL-4, IL-10 and IF N-gamma in CD4+ and CD8+ T lymphocytes and IL-6 and IL-12 in CD14+ monocyte s. Main outcome measures: Intracellular content of the measured cytokines. Results: CD4+ and CD8+ T cells and CD14+ monocytes responded to in vitro st imulation of mitogens and synthesised cytokines to varying degrees in the t hree groups. The heterogeneous cytokine response pattern did not show a typ ical type 1/ type 2 polarised model. Conclusions: This profile suggests that the cells retain the capacity to mo dulate their phenotype in response to local conditions at the effector site . These results could be taken into consideration when designing new and sp ecific treatments for modifying the immune inflammatory response.