Duration of Postoperative Immunosuppression Assessed by Repeated Delayed Type Hypersensitivity Skin Tests

Hammer, Janne H.; Nielsen, Hans Jørgen; Moesgaard, F; Kehlet, Henrik

doi:10.1159/000129199

Cited by 61 publications

(19 citation statements)

References 6 publications

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“…The performance of multiple DTH challenges with the same antigen during the perioperative period has been used as a means of detecting changes in the status of the cell-mediated immune system in response to surgery [11,12,18]. The present study utilized this type of serial DTH testing.…”

Section: Discussionmentioning

confidence: 99%

Postoperative cell mediated immune response is better preserved after laparoscopic vs open colorectal resection in humans

et al. 2003

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The postoperative DTH responses of the open surgery patients were significantly smaller than their preoperative responses. This was not the case for the laparoscopic group (a combination of fully laparoscopic and laparoscopic-assisted resections). When the open and laparoscopic groups results are directly compared, regarding the results of the day of surgery DTH challenges, the LC groups median percent change from baseline was significantly less than that observed in the OC group. These results imply that open colorectal resection is associated with a significant suppression of cell-mediated immune response postoperatively, whereas in this study laparoscopic colorectal resection was not. Further human studies are needed to verify these findings and to determine the clinical significance, if any, of this temporary difference in immune function following colon resection.

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Section: Discussionmentioning

confidence: 99%

Postoperative cell mediated immune response is better preserved after laparoscopic vs open colorectal resection in humans

et al. 2003

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“…Interestingly, we have also shown that suppression of TNF-α and IFN-γ production appears to disappear following resection of the tumour. Surgery is known to result in a transient immune suppression which usually resolves after 6-9 days (Hammer et al, 1992). However, in this study samples were taken from patients prior to surgery and (after tumour resection) at a time distant (greater than 20 weeks) to allow immunosuppression from the surgery itself to resolve.…”

Section: Discussionmentioning

confidence: 99%

Reduction in cytokine production in colorectal cancer patients: association with stage and reversal by resection

Heriot¹,

Marriott

Cookson

et al. 2000

Br J Cancer

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SummaryThe aim of this study was to assess monocyte/macrophage function, as defined by lipopolysaccharide (LPS)-induced production of tumour necrosis factor (TNF)-α, interleukin (IL)-10 and interferon (IFN)-γ by stimulated whole blood cultures in patients with colorectal carcinoma before and after surgical resection. Forty colorectal cancer patients prior to surgery and 31 healthy controls were studied. Heparinized venous blood was taken from colorectal cancer patients prior to surgery and from healthy controls. Serial samples were obtained at least 3-6 weeks post-operatively. Blood was stimulated with LPS for 24 h and supernatants were assayed for TNF-α, IFN-γ and IL-10 by enzyme-linked immunosorbent assay. LPS-induced production of TNF-α and of IFN-γ was reduced in patients with colorectal carcinoma compared to controls (TNF-α, 11 269 pg ml -1 {12 598}; IFN-γ, 0.00 pg ml -1 {226}; median {IQR}) (TNF-α, 20 576 pg ml -1 {11 637}, P < 0.0001; IFN-γ, 1048 {2428}, P = 0.0051, Mann-Whitney U-test). Production in patients after surgery had increased (TNF-α: 17 620 pg ml -1 {7986}; IFN-γ: 410 pg ml -1 {2696}; mean {s.d.}) and were no longer significantly reduced when compared to controls (TNF-α, P = 0.28; IFN-γ, P = 0.76). Production of TNF-α and IFN-γ prior to surgery were reduced to a greater extent in patients with Dukes' stage C tumours compared to those with Dukes' stage A and B stage. There was no difference in IL-10 production between any group. Monocytes/macrophages from patients with colorectal carcinoma are refractory to LPS stimulation as reflected by reduction in TNF-α and IFN-γ production and this is more pronounced in patients with advanced stage tumours. This suppression is not mediated by IL-10 and disappears following surgical resection of the tumour. This provides evidence for tumour induced suppression of immune function in patients with colorectal cancer and identifies a potential therapeutic avenue.

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“…Clinical and animal studies have demonstrated that open surgery is associated with temporary suppression of systemic immune function that is estimated to last 5-9 days postoperatively [4,7,12]. This impairment appears to be directly related to the degree of surgical trauma, although it has also been attributed to exposure of the peritoneal cavity to air [2,19].…”

Section: Abstract: Laparoscopy -Peritoneal Macrophages -Monocytes -Pmentioning

confidence: 99%

Peritoneal macrophage and blood monocyte functions after open and laparoscopic-assisted cecectomy in rats

et al. 2003

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In all instances, the LC group's macrophage results were similar to the AC group's results. OC group macrophages produced significantly more TNF-alpha and less H2O2 than both the AC and LC groups. MHC class II protein expression was less for the OC group than for the AC group. OC group PBMCs produced more TNF-alpha. No differences in PBMC H2O2 release or MHC class II expression were noted. Laparoscopic methods better preserves the baseline values of the parameters studied.

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Duration of Postoperative Immunosuppression Assessed by Repeated Delayed Type Hypersensitivity Skin Tests

Cited by 61 publications

References 6 publications

Postoperative cell mediated immune response is better preserved after laparoscopic vs open colorectal resection in humans

Postoperative cell mediated immune response is better preserved after laparoscopic vs open colorectal resection in humans

Reduction in cytokine production in colorectal cancer patients: association with stage and reversal by resection

Peritoneal macrophage and blood monocyte functions after open and laparoscopic-assisted cecectomy in rats

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