TY - JOUR
T1 - Endotoxin and antiendotoxin antibodies in patients with acute pancreatitis
AU - Buttenschoen, Klaus
AU - Berger, Dieter
AU - Hiki, Naoki
AU - Buttenschoen, Daniela Carli
AU - Vasilescu, Catalin
AU - Chikh-Torab, Fawaz
AU - Seidelmann, Manuela
AU - Beger, Hans G.
PY - 2000
Y1 - 2000
N2 - Objective: To elucidate the time course of endotoxaemia and antiendotoxin antibodies in patients with acute pancreatitis. Design: Prospective clinical study. Setting: University hospital, Germany. Subjects: 25 patients with oedematous (n = 9) or necrotising (n = 16) pancreatitis, and 20 healthy controls. Main outcome measures: Concentrations of endotoxin and immunoglobulins (classes G, M, and A) directed at two lipid A molecules, four lipopolysaccharides, and α-haemolysin of Staphylococcus aureus measurements in plasma during a 12 day period. Results: There were no differences in the degree of endotoxaemia between patients with oedematous and necrotising pancreatitis had significantly higher concentrations of endotoxin than those with oedematous pancreatitis. Concentratons of IgM specific for endotoxin peaked at day 4, and then decreased in patients with oedematous pancreatitis while remaining high for those with necrotising pancreatitis. There was only a slight increase in IgA specific for endotoxin, and IgG and immunoglobulins to α-haemolysin remained steady throughout the observation period. There was strong cross-reactivity (r > 0.7) between IgM specific for endotoxin (70%), but this was less with IgA (52%), and IgG (20%). Conclusions: Necrotising pancreatitis is accompanied by persistent endotoxaemia with an extended rise in antiendotoxin antibodies. Patients with oedematous pancreatitis have a transient endotoxaemia with a temporary increase of Ig specific for endotoxin. Endotoxin stimulates the synthesis of specific antibodies (IgM) despite general immunosuppression.
AB - Objective: To elucidate the time course of endotoxaemia and antiendotoxin antibodies in patients with acute pancreatitis. Design: Prospective clinical study. Setting: University hospital, Germany. Subjects: 25 patients with oedematous (n = 9) or necrotising (n = 16) pancreatitis, and 20 healthy controls. Main outcome measures: Concentrations of endotoxin and immunoglobulins (classes G, M, and A) directed at two lipid A molecules, four lipopolysaccharides, and α-haemolysin of Staphylococcus aureus measurements in plasma during a 12 day period. Results: There were no differences in the degree of endotoxaemia between patients with oedematous and necrotising pancreatitis had significantly higher concentrations of endotoxin than those with oedematous pancreatitis. Concentratons of IgM specific for endotoxin peaked at day 4, and then decreased in patients with oedematous pancreatitis while remaining high for those with necrotising pancreatitis. There was only a slight increase in IgA specific for endotoxin, and IgG and immunoglobulins to α-haemolysin remained steady throughout the observation period. There was strong cross-reactivity (r > 0.7) between IgM specific for endotoxin (70%), but this was less with IgA (52%), and IgG (20%). Conclusions: Necrotising pancreatitis is accompanied by persistent endotoxaemia with an extended rise in antiendotoxin antibodies. Patients with oedematous pancreatitis have a transient endotoxaemia with a temporary increase of Ig specific for endotoxin. Endotoxin stimulates the synthesis of specific antibodies (IgM) despite general immunosuppression.
KW - Endotoxaemia
KW - Immune consequences
KW - Immunoglobulins
KW - Lipopolysaccharide
KW - Specific antibodies
KW - Translocation
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U2 - 10.1080/110241500750008772
DO - 10.1080/110241500750008772
M3 - Article
C2 - 10890542
AN - SCOPUS:0034118453
SN - 1102-4151
VL - 166
SP - 459
EP - 466
JO - European Journal of Surgery
JF - European Journal of Surgery
IS - 6
ER -