Serum soluble PD‐1 plays a role in predicting infection complications in patients with acute pancreatitis

Abstract

Background Most of acute pancreatitis (AP) are mild and self‐limiting, however, 15%–20% of patients develop severe acute pancreatitis (SAP) or moderately acute pancreatitis (MSAP) with local or systemic complications. Infection complications (ICs) result in 40%–70% morbidity and high mortality rates among SAP and MSAP patients. It is more important to early recognize of ICs of MSAP or SAP. Several studies have indicated that serum soluble programmed cell death protein (sPD‐1) or programmed cell death 1 ligand (sPD‐L1) levels were higher in patients with severe sepsis than in healthy volunteers and have a predictive capacity for mortality. However, the role of serum sPD‐1/sPD‐L1 in AP remains unclear. This study aimed to investigate whether the ICs of AP patients is associated with their sPD‐1 and sPD‐L1 levels, which were determined via enzyme‐linked immunosorbent assay of peripheral blood samples from 63 MSAP and SAP patients and 30 healthy volunteers. Results The serum sPD‐1 levels in AP patients on Days 1, 3, and 10 after onset were significantly increased in a time‐dependent manner compared with that in healthy volunteers. Moreover, the AP patients with ICs had significantly higher serum sPD‐1 levels than the AP without ICs. While serum sPD‐L1 levels in AP were similar to that in healthy volunteers. Besides, serum levels of sPD‐1/sPD‐L1 were negatively correlated with circulating lymphocytes. Univariate and multivariate regression analyses showed that the upregulated serum sPD‐1 level was an independent risk factor for ICs in AP. The area under the receiver operating characteristics curve indicated that combination with Acute Physiology and Chronic Health Evaluation II score and serum sPD‐1 level had a high accuracy in predicting ICs in AP. Conclusion Serum sPD‐1/sPD‐L1 may be involved in the immunosuppressive process in AP. Moreover, the serum sPD‐1 level may be an independent risk factor for predicting ICs in AP patients.

Circulating level of sPD-1 and PD-1 genetic variants are associated with hepatitis B infection and related liver disease progression

“…In our study, the circulating sPD-1 levels of HBV patients were significantly higher than those of the control group. The results were consistent with studies in HBV infections (Bi et al, 2018, Li et al, 2017, Zhou et al, 2019, chronic HCV (Wang et al, 2013) and in acute or chronic inflammatory conditions such as pancreatitis (Yu et al, 2021), sepsis (Bakhshiani et al, 2021), autoimmune hepatitis and inflammatory bowel disease (Hadley et al, 2020). These data suggest that increased sPD-1 levels are associated with inflammation and higher inflammation tends to lead to higher plasma sPD-1 levels.…”

Plasma levels of sPD-1 and PD-1 genetic variants are associated with hepatitis B infection and related liver disease progression

“…In our study, the circulating sPD-1 levels of HBV patients were signi cantly higher than those of the control group. The results were consistent with studies in HBV infections 17,44,45 , chronic HCV 46 and in acute or chronic in ammatory conditions such as pancreatitis 47 , sepsis 48 , autoimmune hepatitis and in ammatory bowel disease 49 . These data suggest that increased sPD-1 levels are associated with in ammation and higher in ammation tends to lead to higher plasma sPD-1 levels.…”

Soluble Programmed Death Ligand-1 (sPD-L1): A Pool of Circulating Proteins Implicated in Health and Diseases

“…Upregulation of sPD-L1 in patients with early AP and infectious complications. [ 136 , 137 ] HIV-1 infection (AIDS) Much higher levels of sPD-L1 in HIV-infected patients compared to uninfected adults. [ 138 , 139 ] Acute respiratory distress syndrome (ARDS) sPD-L1 upregulated in survivors of direct ARDS compared to non-survivors.…”

“…The circulating protein is suspected to be involved in the development of immunosuppression in the early stage of the disease [ 136 ]. Both serum sPD-1 and sPD-L1, negatively correlated with circulating lymphocyte levels, likely contribute to the immunosuppressive process in acute pancreatitis [ 137 ]. A major elevation of the level of circulating sPD-L1 might be the cause or the reflect of a generalized inflammation in AP, just as observed in inflammatory types of pancreatic cancer [ 163 ].…”