Circulating Blood Lymphocytes and Acute Pancreatitis Severity: A Systematic Review

Abstract

Acute pancreatitis is an acute inflammatory process of the pancreas with high prevalence and varying degrees of severity that can be potentially life-threatening. Much is still unknown about which mechanisms determine the course and severity of acute pancreatitis. The primary objective of this review is to identify the potential association between circulating lymphocytes and the severity of acute pancreatitis. A systematic search was performed in Medline, Web of Science, Cochrane Central Register of Controlled Trials and ClinicalTrails.gov. The authors independently did the selection process as well as data extraction that was recorded into a flow diagram following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Our initial search identified 27,783 studies which were narrowed down to 13 by applying strict inclusion and exclusion algorithms. The consistent findings across the studies indicated that peripheral blood lymphocytes are related to acute pancreatitis severity.

Predictive and Prognostic Potentials of Lymphocyte-C-Reactive Protein Ratio Upon Hospitalization in Adult Patients with Acute Pancreatitis

“…Similarly, other non-specific biomarkers from CBC such as LYMPH, neutrophil-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were also associated with disease severity and adverse outcomes in adult patients with AP. [32][33][34] In addition, a 5-cytokine panel, including angiopoietin 2, hepatocyte growth factor, interleukin 8, resistin, and soluble tumor necrosis factor receptor 1A, can accurately predict persistent organ failure (POF) at the early stages of the disease process in patients with AP. 35 Finally, novel digital tool and mechanistic model are also being attempted to forecast disease severity in patients with AP.…”

Immune markers of severe acute pancreatitis

“…The role of adaptive immune cells have been less studied in comparison to the cytokines and innate immune system cells, partly due to the cost and limited availability of the immunophenotyping techniques involved in human AP. Several small human studies investigated the association of different immune cell population's association with development of SAP and/or infected necrosis [78][79][80][81][82]. These studies have focused on the CD4 þ /CD8 þ ratio [81], circulating CD4 þ T helper cells [83,84], Th1, Th2 cells [85], Th17 [86], T reg cells [87], CD8 þ T cells [88], CD19 þ B cells, and regulatory B cells [89].…”