Correlation study between blood cytokines and lymphocytes in early postoperative critical patients with compromised immune function

Abstract

Major surgery due to traumatic injury can activate early systemic postoperative pro-inflammatory responses and postoperative immunosuppression. However, the interaction between them is complex and not entirely clear. This study was performed in postoperative patients admitted to the intensive care unit (ICU) to elucidate the correlation between the systemic cellular immunity function and circulating cytokines levels in the early postoperative period. Twenty-four cases of postoperative patients admitted to the ICU were enrolled in this study. Twelve hours after admission, blood routine examination and measurement of circulating cytokines (interleukin-2 [IL-2], IL-4, IL-6, IL-10, IL-17A, interferon-γ, tumor necrosis factor-alpha [TNF-α], TNF-β, granulocyte-colony stimulating factor [G-CSF], and granulocyte-macrophage colony-stimulating factor [GM-CSF]) were performed. The correlation analysis between cytokines levels and absolute peripheral blood lymphocyte count or lymphocytes/neutrophils ratio was analyzed. The cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, G-CSF, and GM-CSF) levels were increased above the normal upper limit at 12 hours after surgery. The number of leukocytes and neutrophils were markedly increased. In contrast, the absolute count and relative ratio of lymphocytes decreased below the lower normal limit. Spearman correlation analysis showed a moderate negative correlation between absolute peripheral blood lymphocyte count and IL-2 or IL-4 level. A low-negative correlation between absolute peripheral blood lymphocyte count and GM-CSF levels was detected. We also found that lymphocytes/neutrophils ratio was also negatively correlated with plasma IL-2, IL-4, or GM-CSF level. In ICU patients with compromised immune function in the early postoperative period, the elevated levels of IL-2, IL-4, and GM-CSF may be the compensatory responses to systemic immunosuppression.

Dyslipidemia and SARS‐CoV‐2 spike antibody titres after the second and third doses of the BNT162b2 vaccine among healthcare workers in Japan

“…The absolute level of peripheral blood lymphocytes, which are divided into T , B , and natural killer cells, is a critical immune function modulator 20,21 . Because B cells are mainly responsible for antibody production and T cells help to stimulate this process, 22,23 an increase in peripheral lymphocyte count is associated with immune dysfunction. A Japanese study reported that hypertriglyceridemia was associated with elevated lymphocyte counts in men but not in women 24 .…”

Very-Short-Term Sleep Deprivation Slows Early Recovery of Lymphocytes in Septic Patients

“…Patients with sepsis caused by pathogenic infections, including bacteria and viruses, typically present lymphopenia (15,(33)(34)(35)(36), which can serve as a biomarker for immunosuppression (37,38). In addition, a continuous and sustained decrease in total circulating lymphocytes is closely associated with disease aggravation and death in septic patients (33,39).…”

“…Albumin preconditioning could abrogate the lipopolysaccharides (LPS)mediated increase in the protein levels of tumor necrosis factor alpha (TNF-α) in cultured macrophages and septic mice (44). Due to the negative correlation between hyperinflammation and systemic immune function (38,45,46), hyperinflammation mediated by reduced levels of albumin in the poor sleep group would also compromise the immune function. ANP, a cardiovascular hormone mainly secreted by the heart atria (47), plays important protective roles in many diseases, including ventricular hypertrophy, myocardial injury, atherosclerosis, hypertension, tumor, acute lung injury, ischemia/reperfusion injury, and sepsis (48,49).…”

“…Surprisingly, the plasma ANP levels at 24 h after inclusion were significantly positively correlated to ALC recovery on day 5 after inclusion, indicating that ANP might play important roles in sleep-mediated immunoregulation. The promoting effects of ANP on the early recovery of immune function may be due to its anti-inflammatory effects (48)(49)(50)(51)(52)(53)(54)56) because hyperinflammation is negatively associated with systemic immune function (38,45,46). In addition, ANP can also affect the adaptive immunity, being able to stimulate the differentiation of naïve CD4 + cells (48) and promote dendritic cell-mediated T cell polarization (57) mediated by its principal receptor GC-A, which is highly expressed in thymus (58) and immune cells (including macrophages, dendritic cells, and T lymphocytes) (59).…”

“…Albumin preconditioning could abrogate the lipopolysaccharides (LPS)-mediated increase in the protein levels of tumor necrosis factor alpha (TNF-α) in cultured macrophages and septic mice ( 44 ). Due to the negative correlation between hyperinflammation and systemic immune function ( 38 , 45 , 46 ), hyperinflammation mediated by reduced levels of albumin in the poor sleep group would also compromise the immune function.…”