Abnormal Cytokine Serum Levels Correlate with Impaired Cellular Immune Responses after Surgery

Baxevanis, Constantin N.; Papilas, Konstantinos; Dedoussis, George; T, Pavlis; Papamichail, Michael

doi:10.1006/clin.1994.1055

Cited by 86 publications

(43 citation statements)

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“…3,23,24 To date, there are no randomized data comparing the immunosuppressive effects elicited by two standardized major surgical interventions. The random allocation of our patients enabled us to evaluate host immune responses after limited transhiatal esophagectomy (THE) versus extended transthoracic esophagectomy (TTE) …”

Section: Discussionmentioning

confidence: 99%

Immune Responses and Prediction of Major Infection in Patients Undergoing Transhiatal or Transthoracic Esophagectomy for Cancer

Sandick¹,

Gisbertz²,

Berge³

et al. 2003

Annals of Surgery

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ObjectiveTo investigate alterations in immune responses after transhiatal versus transthoracic esophageal resection and to evaluate the role of preoperative immune functions in predicting postoperative infectious complications. Summary Background DataImpaired immune defense is associated with a decreased resistance to infection. Patients undergoing esophageal resection via a transhiatal or transthoracic approach are prone to develop infectious complications. There are no randomized data on immune responses after two major surgical interventions. MethodsThe study group consisted of 20 patients who were randomly allocated to a limited transhiatal or extended transthoracic esophagectomy for cancer. Blood samples were taken before the operation and at regular intervals thereafter from day 1 to day 10. Monocyte and T-helper type 1 (Th1) and type 2 (Th2) lymphocyte functions were assessed in stimulated whole blood cultures.

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Section: Discussionmentioning

confidence: 99%

Immune Responses and Prediction of Major Infection in Patients Undergoing Transhiatal or Transthoracic Esophagectomy for Cancer

Sandick¹,

Gisbertz²,

Berge³

et al. 2003

Annals of Surgery

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“…31,[36][37][38][39] The inflammatory state involves increases in tumour necrosis factor-α, interleukin (IL)-1, IL-6 and Creactive protein; these factors may have a direct role in initiating plaque fissuring and acute coronary thrombosis. 38,[40][41][42] The hypercoagulable state involves increases in plasminogen activator inhibitor-1, factor VIII and platelet reactivity, as well as decreases in antithrombin III; all of these factors can lead to acute coronary thrombosis. 31,43,44 The stress state involves increased levels of catecholamines (epinephrine and norepinephrine) and cortisol.…”

Section: Triggers Of Perioperative Myocardial Infarctionmentioning

confidence: 99%

Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk

Devereaux

Goldman

Cook

et al. 2005

CMAJ

571

350

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THIS IS THE FIRST OF 2 ARTICLES EVALUATING cardiac events in patients undergoing noncardiac surgery. In this article, we review the magnitude of the problem, the pathophysiology of these events, approaches to risk assessment and communication of risk. The number of patients undergoing noncardiac surgery worldwide is growing, and annually 500 000 to 900 000 of these patients experience perioperative cardiac death, nonfatal myocardial infarction (MI) or nonfatal cardiac arrest. Although the evidence is limited, a substantial proportion of fatal perioperative MIs may not share the same pathophysiology as nonoperative MIs. A clearer understanding of the pathophysiology is needed to direct future research evaluating prophylactic, acute and long-term interventions. Researchers have developed tools to facilitate the estimation of perioperative cardiac risk. Studies suggest that the Lee index is the most accurate generic perioperative cardiac risk index. The limitations of the studies evaluating the ability of noninvasive cardiac tests to predict perioperative cardiac risk reveals considerable uncertainty as to the role of these popular tests. Similarly, there is uncertainty as to the predictive accuracy of the American College of Cardiology / American Heart Association algorithm for cardiac risk assessment. Patients are likely to benefit from improved estimation and communication of cardiac risk because the majority of noncardiac surgeries are elective and accurate risk estimation is important to allow informed patient and physician decision-making

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“…With respect to protecting NK activity against suppression by surgery, catecholamines and prostaglandins, both released during surgery (Baxevanis et al, 1994;Koltun et al, 1996), suppress NK activity by increasing intracellular cAMP levels (Malygin et al, 1993;Whalen and Bankhurst, 1990). In vitro studies indicate that interferons, which are secreted following poly I-C challenge, can reduce the intracellular rise in lymphocyte's cAMP, thus reducing the suppression of NK activity by catecholamines and prostaglandins, (Davis et al, 1984).…”

Section: Discussionmentioning

confidence: 99%

Inducing a mode of NK-resistance to suppression by stress and surgery: A potential approach based on low dose of poly I–C to reduce postoperative cancer metastasis

Rosenne

Shakhar

Melamed

et al. 2007

Brain, Behavior, and Immunity

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Perioperative suppression of NK activity has been suggested to compromise host resistance to tumor progression. Here we sought to develop a clinically applicable pre-operative regimen to prevent immunosuppression and promotion of metastasis by stress or surgery. The synthetic ds-RNA, poly I-C, was used in vivo in F344 rats, based on its alleged in vitro ability to protect immunocytes from suppression by cAMP elevating agents. Different regimens of poly I-C were studied in controls and in rats subjected to a pharmacological stressor, swim stress, or surgical stress. Resistance to lung experimental metastasis of the syngeneic non-immunogenic MADB106 mammary adenocarcinoma was assessed. Numbers of circulating and marginating-pulmonary NK cells and their cytotoxicity against the MADB106 and YAC-1 target lines were also studied. Our findings established a regimen of repeated low-dose poly I-C administration with minimal side effects (0.2 mg/kg i.p. 5, 3, & 1 day before tumor inoculation). This regimen, while hardly affecting resistance levels in non-stressed animals, prevented all stressors from promoting metastases. These beneficial effects occurred in the presence of a primary tumor and in both sexes. Poly I-C increased the numbers of NK cells, and, on a per NK cell basis, while not increasing cytotoxicity, profoundly protected marginating-pulmonary NK cells from suppression by surgery. This study suggests a non-toxic clinically-translatable prophylactic use of poly I-C to target the critical perioperative period. By increasing the number of marginating-pulmonary NK cells, and by transforming them into a mode of resistance to immunosuppression, this approach may reduce postoperative metastasis in cancer patients.

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Abnormal Cytokine Serum Levels Correlate with Impaired Cellular Immune Responses after Surgery

Cited by 86 publications

References 0 publications

Immune Responses and Prediction of Major Infection in Patients Undergoing Transhiatal or Transthoracic Esophagectomy for Cancer

Immune Responses and Prediction of Major Infection in Patients Undergoing Transhiatal or Transthoracic Esophagectomy for Cancer

Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk

Inducing a mode of NK-resistance to suppression by stress and surgery: A potential approach based on low dose of poly I–C to reduce postoperative cancer metastasis

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