Distributional and functional alterations of immunocompetent peripheral blood lymphocytes in patients with chronic pancreatitis.

Objective: To investigate whether the chronic inflammatory process in patients with chronic pancreatitis affects their immune function.

Summary Background Data: Chronic pancreatitis is a chronic inflammatory disease of the exocrine pancreas. In approximately 30% of patients, an inflammatory mass of the pancreatic head is found, representing an indication for surgery.

Methods: This study comprised 28 patients with chronic pancreatitis. Sixteen patients were also reevaluated 1 year after resection of the pancreatic head for chronic pancreatitis.

Results: Compared with an age- and gender-matched control group, the number of CD3(+) cells was significantly increased in patients with chronic pancreatitis, with an increase of both CD3(+)CD4(+) and CD3(+)CD8(+) cells. The number of natural killer cells or B lymphocytes did not differ between the patients and the control group. After stimulation with phytohemagglutinin or anti-CD3 antibodies, the blastogenic response was significantly attenuated in the patients with chronic pancreatitis. One year after resection of the pancreatic head for chronic pancreatitis, the distribution and the blastogenic response to phytohemagglutinin and anti-CD3 antibodies had returned to normal compared with preoperative values.

Conclusion: The chronic inflammatory process in chronic pancreatitis markedly affects the distribution and function of peripheral immunocompetent blood cells, and elimination of the chronic inflammatory focus by pancreatic head resection restores the suppressed immune function in these patients.