Nuclear factor kappa B expression in peripheral blood mononuclear cells of patients with acute pancreatitis

Introduction: Although many experimental studies have implicated the activation of nuclear factor kappa B (NF-κB) as a pivotal step in the pathobiology of acute pancreatitis, no clinical investigations have been reported. Aim: To investigate the expression of NF-κB and its characteristics in peripheral blood mononuclear cells (PBMCs) of patient with acute pancreatitis. Methodology: Forty-five patients were prospectively enrolled. The expression of NF-κB in PBMCs was measured in the patients by electrophoretic mobility shift assay at admission and 14 days after the onset of acute pancreatitis. Twelve healthy individuals were also included as control subjects. Results: At admission, the PBMCs from patients with acute pancreatitis showed higher levels of NF-κB activities than did those from control subjects. In vitro, the lipopolysaccharide (LPS) treatment of the PBMCs from the control subjects and patients with mild pancreatitis induced further activation of the NF-κB. The response was significantly reduced in patients with severe pancreatitis. Patients who had persistently high NF-κB activities, a reduced response of NF-κB to LPS, and a low p50p65:p50p50 ratio after LPS stimulation at 14 days developed serious systemic complications in the later clinical course. Conclusions: An alteration of the characteristics of PBMCs occurs in the early phase of acute pancreatitis and may predispose patients to a higher risk of serious systemic complications.