HLA-DR expression in acute pancreatitis

Objective: To investigate the role of the monocyte/macrophage system in acute pancreatitis Design: Prospective clinical study Setting: University clinic, Germany Subject: 37 consecutive patients who presented with acute pancreatitis. Main outcome measure: Correlation between function of monocytes measured by HLA-DR expression and outcome Results: Patients were divided into three groups according to outcome : those with severe pancreatitis who died (n = 10), those with severe pancreatitis who survived (n = 15), and those with mild pancreatitis who survived (n = 12). There was a clear and significant difference between those with severe and those with mild disease. HLA-DR expression was initially depressed in both groups, but after the third day of treatment it started to recover significantly in those with mild disease (p < 0.05). The difference was also significant from day 7 onwards between those with severe disease who died and those with severe disease who survived (p < 0.05). Conclusion: Monocyte function as measured by HLA-DR expression (CD14+DR+) is reduced in patients with acute pancreatitis and does not recover in patients who are going to die (median < 20 relative antigen density units; RU).