Blood Leukocyte Signaling Pathways as Predictors of Severity of Acute Pancreatitis

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Turunen , A , Kuuliala , A , Mustonen , H , Puolakkainen , P , Kylänpää , L & Kuuliala , K 2021 , ' Blood Leukocyte Signaling Pathways as Predictors of Severity of Acute Pancreatitis ' , Pancreas , vol. 50 , no. 5 , pp. 710-718 . https://doi.org/10.1097/MPA.0000000000001832

Title: Blood Leukocyte Signaling Pathways as Predictors of Severity of Acute Pancreatitis
Author: Turunen, Antti; Kuuliala, Antti; Mustonen, Harri; Puolakkainen, Pauli; Kylänpää, Leena; Kuuliala, Krista
Contributor: University of Helsinki, HUS Abdominal Center
University of Helsinki, Medicum
University of Helsinki, HUS Abdominal Center
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Medicum
Date: 2021
Language: eng
Number of pages: 9
Belongs to series: Pancreas
ISSN: 0885-3177
URI: http://hdl.handle.net/10138/333899
Abstract: Objectives Clinical practice lacks biomarkers to predict the severity of acute pancreatitis (AP). We studied if intracellular signaling of circulating leukocytes could predict persistent organ dysfunction (OD) and secondary infections in AP. Methods A venous blood sample was taken from 174 patients with AP 72 hours or less from onset of symptoms and 31 healthy controls. Phosphorylation levels (p) of appropriately stimulated signal transducer and activator of transcription 1 (STAT1), STAT6, nuclear factor-kappa B (NF-kappa B), Akt, and nonstimulated STAT3 in monocytes, neutrophils, and lymphocytes was measured using phosphospecific flow cytometry. Results The patients showed higher pSTAT3 and lower pSTAT1, pSTAT6, pNF-kappa B, and pAkt than healthy controls. pSTAT3 in all leukocyte subtypes studied increased, and pSTAT1 in monocytes and T cells decreased in an AP severity-wise manner. In patients without OD at sampling, high pSTAT3 in monocytes and T lymphocytes were associated with development of persistent OD. In patients with OD, low interleukin-4-stimulated pSTAT6 in monocytes and neutrophils and Escherichia coli-stimulated pNF-kappa B in neutrophils predicted OD persistence. High pSTAT3 in monocytes, CD8(+) T cells, and neutrophils; low pSTAT1 in monocytes and T cells; and low pNF-kappa B in lymphocytes predicted secondary infections. Conclusions Leukocyte STAT3, STAT1, STAT6, and NF-kappa Beta phosphorylations are potential predictors of AP severity.
Subject: pancreatitis
prognosis
blood
leukocytes
signal transduction
flow cytometry
NF-KAPPA-B
ORGAN FAILURE
INFLAMMATION
DYSFUNCTION
SEPSIS
STAT3
ASSOCIATION
ACTIVATION
TOLERANCE
THERAPIES
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
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