FUNCTIONAL ACTIVITY OF NEUTROPHILS AND HEMOSTASIS PATTERN IN PATIENTS WITH ACUTE DESTRUCTIVE PANCREATITIS

Abstract

The aim of present study was to investigate relationships between indicators of functional activity of neutrophilic granulocytes, and hemostasis parameters in patients with acute destructive pancreatitis (ADP). The study included thirty-three patients with ADP. 35 healthy persons were examined as a control group. The phagocytosis level in neutrophils was determined by flow cytometry using FITC-labeled staphylococcal protein A. We have calculated the percentage of fluorescent neutrophils as phagocytic index, and average cell fluorescence assumed phagocytic number. The intensity of respiratory burst observed in neutrophil samples was evaluated using chemiluminescence assay. All the persons under study were also tested for blood coagulation and vascular-platelet hemostasis. It was found that the ADP patients with decreased number of phagocytic neutrophils in the blood showed a decrease in respiratory burst intensity in the neutrophils. Moreover, spontaneous and induced synthesis of the primary reactive oxygen species (ROS) in neutrophils of ADP patients proceeded faster than in healthy people, but its intensity was much lower. The maximal level of spontaneous and induced synthesis of secondary ROS in neutrophils of patients was significantly higher than in healthy individuals, but its rapid may be generally characterized by insufficient respiratory burst in these patients. A reduced neutrophil phagocytic activity and kinetic characteristics of primary and secondary ROS synthesis may be attributed to the effects produced by pancreatic enzymes entering blood flow which may alter functional activity of the blood neutrophils. Concerning hemostasis in patients with ADP, some disturbances were found only in the coagulation link which seem to depend on increase in fibrinogen, soluble fibrin monomer complexes and D-dimer in blood plasma, along with reduced antithrombin III levels. Such a change in blood coagulation indexes is typical to inflammatory processes and presumes activation of the coagulation cascade and higher risk of septic complications. In patients with ADP, we have found a significantly increased number of correlations between indicators of functional activity of neutrophils and hemostasis parameters. This analysis revealed a relationship by the patients with ADP reflect some unidirectional changes in functional activity of neutrophils (as phagocytosis and respiratory burst), and blood coagulation parameters (as blood clotting and vascular/ platelet links). The changes in functional activity of neutrophils and the state of hemostasis in the ADP patients, as well as correlations between their alterations are omvolved into the pathogenesis of this disorder, and determine potential mechanisms for evolving complications.

Keywords

• acute pancreatitis
• neutrophils
• hemostasis
• functional activity
• phagocytosis
• respiratory burst