Early immune response in post endoscopic retrograde cholangiopancreatography pancreatitis as a model for acute pancreatitis

Table 2 Role of immune components in predicting disease severity

	Acute pancreatitis	Post-endoscopic pancreatitis
Monocytes and macrophages	(1) Expression of HLA-DR on monocytes gives a good insight into monocyte function; (2) Decreased monocyte HLA-DR expression may serve as an indicator of immunosuppression[13]; and (3) Decreased monocyte HLA- DR expression predicts the development of organ dysfunction in severe acute pancreatitis[13].
T cells	(1) CD4+ lymphocytes are reported to have a direct cytotoxic effect on acinar cells[14]; (2) Depletion of CD4+ lymphocytes reduces the severity of acute pancreatitis[15]; and (3) Reduction in the number of cytotoxic T lymphocytes (CD3+CD8+) in severe form of acute pancreatitis[16].
Natural Killer cells	(1) Depletion of the natural killer cell population on the first day of severe acute pancreatitis[16]; and (2) No significant change in natural killer cell number in mild acute pancreatitis[16].
IL-10	Predictive marker of organ failure in severe acute pancreatitis[17].	Conflicting results about reducing the incidence of post endoscopic retrograde cholangiopancreatography acute pancreatitis after IL-10 usage[18,19].
IL- 6	Independent factor for predicting severity in acute non- endoscopic retrograde cholangiopancreatography pancreatitis[7].	(1) Peak value 24-48 h after clinical expression of post endoscopic pancreatitis; and (2) In necrotising post endoscopic pancreatitis, the peak levels of IL-6 occur after 24 h[6].
IL-1β	(1) Required for full pancreatic and distal organ injury and inflammation[20]; and (2) Values peak after 24 h and are larger in patients with severe acute pancreatitis compared to mild acute pancreatitis, although a strong correlation with acute pancreatitis severity in humans wasn’t found[21].