Chemokine receptor 8 expression may be linked to disease severity and elevated interleukin 6 secretion in acute pancreatitis

Metabolites and Lipoproteins May Predict the Severity of Early Acute Pancreatitis in a South African Cohort

Background: Acute pancreatitis (AP) can be life-threatening with unpredictable severity. Despite advances in management, its pathogenesis remains unclear. This study investigated metabolites and lipoprotein profiles in AP patients of African descent to understand the underlying pathophysiological conditions so as to inform prognosis and management. Methods: Serum samples were collected from 9 healthy controls (HCs) and 30 AP patients (8 with mild AP, 14 with moderately severe AP, and 8 with severe AP) on days 1, 3, 5, and 7 post epigastric pain and subjected to nuclear magnetic resonance (NMR) spectroscopy. Wilcoxon and Kruskal-Wallis rank-sum tests compared numerical covariates. Lipoprotein characterization was performed using the Liposcale test, and Spearman's rank test assessed data correlations. The p-values < 0.05 indicated significance. Results: Thirty-eight metabolic signals and information on lipoprotein subclasses were identified from the NMR spectra. The severity of AP correlated with increased levels of 3-hydroxybutyrate and acetoacetate and decreased levels of ascorbate. Distinct metabolic phenotypes were identified and characterized by unique inflammatory and lipoprotein profiles. High-density lipoprotein cholesterol (HDL-C) decreased across all the metabolic phenotypes of AP when compared with the HC, while elevated immediate density lipoprotein cholesterol (IDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels were observed. Time-dependent changes in metabolites were indicative of responsiveness to therapy. Conclusions: Our findings indicate that dysregulated metabolites and lipoproteins can be used to differentiate AP disease state and severity. Furthermore, integrating clinical parameters with data on metabolic and lipoprotein perturbations can contribute to a better understanding of the complex pathophysiology of AP.

Comparative immune profiling of pancreatic ductal adenocarcinoma progression among South African patients

BACKGROUND

Pancreatic Ductal Adenocarcinoma (PDAC) is an aggressive cancer characterized by an immunosuppressive microenvironment. Patients from specific ethnicities and population groups have poorer prognoses than others. Therefore, a better understanding of the immune landscape in such groups is necessary for disease elucidation, predicting patient outcomes and therapeutic targeting. This study investigated the expression of circulating key immune cell markers in South African PDAC patients of African ancestry.

METHODS

Blood samples were obtained from a total of 6 healthy volunteers (HC), 6 Chronic Pancreatitis (CP) and 34 PDAC patients consisting of 22 resectable (RPC), 8 locally advanced (LAPC) and 4 metastatic (MPC). Real-time Quantitative Polymerase Chain reactions (RT-qPCR), Metabolomics, Enzyme-Linked Immunosorbent Assay (ELISA), Reactive Oxygen Species (ROS), and Immunophenotyping assays were conducted. Statistical analysis was conducted in R (v 4.3.2). Additional analysis of single-cell RNA data from 20 patients (16 PDAC and 4 controls) was conducted to interrogate the distribution of T-cell and Natural Killer cell populations.

RESULTS

Granulocyte and neutrophil levels were significantly elevated while lymphocytes decreased with PDAC severity. The total percentages of CD3 T-cell subpopulations (helper and double negative T-cells) decreased when compared to HC. Although both NK (p = 0.014) and NKT (p < 0.001) cell levels increased as the disease progressed, their subsets: NK CD56dimCD16- (p = 0.024) and NKTs CD56+ (p = 0.008) cell levels reduced significantly. Of note is the negative association of NK CD56dimCD16- (p < 0.001) cell levels with survival time. The gene expression analyses showed no statistically significant correlation when comparing the PDAC groups with the controls. The inflammatory status of PDAC was assessed by ROS levels of serum which were elevated in CP (p = 0.025), (RPC (p = 0.003) and LAPC (p = 0.008)) while no significant change was observed in MPC, compared to the HC group. ROS was shown to be positively correlated with GlycA (R = 0.45, p = 0.0096). Single-cell analyses showed a significant difference in the ratio of NKT cells per total cell counts in LAPC (p < 0.001) and MPC (p < 0.001) groups compared with HC, confirming observations in our sample group.

CONCLUSION

The expression of these immune cell markers observed in this pilot study provides insight into their potential roles in tumour progression in the patient group and suggests their potential utility in the development of immunotherapeutic strategies.

Circulating monocytes in acute pancreatitis

Acute pancreatitis is a common gastrointestinal disease characterized by inflammation of the exocrine pancreas and manifesting itself through acute onset of abdominal pain. It is frequently associated with organ failure, pancreatic necrosis, and death. Mounting evidence describes monocytes - phagocytic, antigen presenting, and regulatory cells of the innate immune system - as key contributors and regulators of the inflammatory response and subsequent organ failure in acute pancreatitis. This review highlights the recent advances of dynamic change of numbers, phenotypes, and functions of circulating monocytes as well as their underling regulatory mechanisms with a special focus on the role of lipid modulation during acute pancreatitis.