CHANGES IN THE EXPRESSION OF CD184 AND CD195 ON VARIOUS SUBPOPULATIONS OF MONOCYTES IN PATIENTS WITH ACUTE PANCREATITIS DURING COMPLEX TREATMENT WITH CYTOFLAVIN

Abstract

The development of treatments for acute pancreatitis (AP) should consider their impact on immunopathogenesis. Monocytes play a key role in innate and adaptive immune responses in AP. Cytoflavin has immunocorrective effects but lacks data on its influence on monocyte function.

Aim: To investigate the effect of cytoflavin on CD184 and CD195 expression in monocyte subpopulations during AP treatment.

Materials and methods.  35 patients (mean age 48.7±5.8 years) with moderate and severe AP were divided into two groups: 18 received standard therapy, 17 received cytoflavin. Blood samples were taken before and after 14 days of treatment. Control group: 32 healthy age-matched individuals. Monocyte subsets were analyzed by flow cytometry.

Results. Patients with AP before the start of treatment showed an increase in the number of CD14⁺CD16⁺ monocytes, the level of which normalized after treatment with cytoflavin. The number of CD14⁺⁺CD16^-CD184⁺ and CD14⁺CD16⁺CD184⁺ monocytes increases in patients with AP before the start of treatment, as does the level of receptor expression on these subsets. The content of monocytes with these phenotypes doesn’t change after standard treatment but increases significantly with treatment with cytoflavin. In AP, before treatment, monocyte subpopulations expressing CD195 increase. After treatment with cytoflavin, the level of CD195+ “classical” and “transitional” monocytes decreases, while the level of CD195 expression increases on “transitional” and “non-classical” monocytes.

Conclusion. The inflammatory reaction in patients with AP before the start of treatment is characterized by the presence of compensatory processes due to an increase in the content of monocytes with anti-inflammatory function. Increased numbers of monocytes express CXCR4 and CCR5 during the acute phase of the disease. Conventional therapy doesn’t lead to changes in the subset composition of monocytes and the number of cells expressing CXCR4 and CCR5. After treatment with cytoflavin, the subpopulation composition of monocytes is normalized, a redistribution of migrating monocytes is observed: the content of proinflammatory cells decreases and the level of cells with anti-inflammatory and antigen-presenting activity increases.