The Decrease of Peripheral Blood CD4+ T Cells Indicates Abdominal Compartment Syndrome in Severe Acute Pancreatitis.

Area of Science:

• Immunology
• Gastroenterology
• Critical Care Medicine

Background:

• Abdominal compartment syndrome (ACS) is a severe complication of severe acute pancreatitis (SAP).
• The role of T lymphocytes and inflammatory cytokines in ACS development within SAP remains under-investigated.

Purpose of the Study:

• To investigate the association between T lymphocyte subsets and inflammatory markers with ACS in patients with SAP.
• To identify potential risk factors and predictors for ACS in SAP.

Main Methods:

• Retrospective analysis of 76 SAP patients, comparing 36 with ACS and 40 with intra-abdominal hypertension (IAH).
• Assessment of C-reactive protein (CRP), CD4+ and CD8+ T lymphocyte proportions, APACHE II score, and CTSI score at various time points post-admission.

Main Results:

• ACS patients exhibited higher CRP on day 7 and lower proportions of CD4+ T cells on days 1, 3, and 7 compared to IAH patients.
• A CD4+ T cell proportion of 30.3% on day 1 showed high predictive value for ACS (AUC 0.774, sensitivity 82.5%, specificity 72.0%).
• CD4+/CD8+ ratio and APACHE II score also demonstrated predictive capabilities for ACS.

Conclusions:

• A decrease in peripheral blood CD4+ T lymphocytes is significantly associated with the presence of ACS in SAP.
• Peripheral blood CD4+ T lymphocyte counts may serve as a valuable and early predictor for ACS in patients with SAP.