Changes in immune status and cytoarchitectonics of neutrophil granulocytes during development of acute necrotic pancreatitis

Abstract

The aim of the study is to study changes in immune status indicators and cytoarchitectonics of neutrophil granulocytes in patients with a severe course of acute necrotic pancreatitis. Materials and methods. The subject of the study was 32 patients aged 37 to 59 years, diagnosed with acute necrotizing pancreatitis, severe course, early phase. The control group was 30 donors, comparable by sex and age to the main group. Upon admission, atomic force microscopy of neurophilic granulocytes was performed to determine its shape, state of the membrane, geometric dimensions, and the immune status and chemical composition of the neutrophil were also evaluated. Results. During the development of severe acute pancreatitis in the early phase, immune inhibition along the cell link is recorded, a decrease in the concentration of immunoglobulins A and M. During atomic force microscopy, violations of the structural organization of the neutrophil granulocyte were found. Changes in the chemical state of the neutrophil were recorded, a significant decrease in the content of oxygen, sodium and calcium was revealed, which confirms the role of cellular hypoxia and apoptosis in the development of systemic inflammation. With an increase in the degree of severity of mechanical jaundice, the neutrophil acquired a convex shape, the number of nucleus segments increased, the cell membrane became not even, the neutrophil volume reached 61.58 ± 4.65 μm3. The value of neutrophil adhesion forces fell by 31% in severe pancreatitis. Conclusion. The severity of acute pancreatitis is due to the inhibition of the immune system and the functional capabilities of neutrophil granulocytes, leading to the generalization of the inflammatory reaction and the development of multi-organ insufficiency.