Effects of surgery on neutrophil granulocyte function

El-Maallem, Hilal; Fletcher, J.

doi:10.1128/iai.32.1.38-41.1981

Cited by 56 publications

(14 citation statements)

References 18 publications

(22 reference statements)

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“…More recent reports have revealed evidence of an activation rather than a depression of neutrophils in the early postoperative period ( 1 1, 27). As for non-infected patients, our results confirm these observations and are in good agreement with studies showing unchanged or even enhanced PMN functions following non-cardiovascular major surgery (28)(29)(30)(31). It is suggested that these changes are due to an in vivo activation of circulating neutrophils (28).…”

Section: Discussionsupporting

confidence: 92%

Predictive value of skin testing, neutrophil migration and C‐reactive protein for postoperative infections in cardiopulmonary bypass patients

Kress

Gehrsitz

Elert

1987

Acta Anaesthesiol Scand

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Despite antibiotic cover for cardiac surgery the development of postoperative infection remains a feared complication. The present prospective study was designed to evaluate whether it is possible to identify preoperatively those individuals in whom the risk of a postoperative infection is significantly greater. Skin test response, chemotaxis and random migration of neutrophils, and serum levels of C-reactive protein (CRP) were chosen as indicators of host resistance. Pre-operatively and at defined postoperative time intervals, 80 patients undergoing open-heart surgery with the aid of cardiopulmonary bypass were examined. Of all the immunological variables measured in this study, the state of anergy proved the most reliable predictor of postoperative infection. Six of the nine pre-operatively anergic patients developed infections (P = 0.00026) representing one half of the postoperatively infected patients. No predictive role of CRP level or neutrophil chemotaxis can be derived from our data. The pre-operatively decreased random migration of polymorphonuclear leukocytes (PMN) from postoperatively infected patients, however, along with the significant defects in chemotactic and random PMN motility seen after cardiac surgery may partly explain the predisposition to bacterial infection in these patients. In conclusion, a pre-operative skin test makes a valuable contribution to the assessment of the patient's postoperative infectious risk.

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Section: Discussionsupporting

confidence: 92%

Predictive value of skin testing, neutrophil migration and C‐reactive protein for postoperative infections in cardiopulmonary bypass patients

Kress

Gehrsitz

Elert

1987

Acta Anaesthesiol Scand

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“…Such changes are associated with the development of defects in neutrophil function and may predispose to secondary infection (Davies et al, 1980). Similar defects in neutrophil function have been observed in patients undergoing major surgery (Bowers et al, 1977;El-Maallem & Fletcher, 1981). The present study was undertaken to determine whether major surgery was also accompanied by changes in levels of neutrophil granule proteins.…”

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confidence: 68%

The effects of surgery on the activity of neutrophil granule proteins

1983

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Activities of the neutrophil granule-associated proteins beta-glucuronidase, lysozyme and vitamin B12 binding protein were measured, serially, in the cells and serum of 10 patients undergoing total abdominal hysterectomy. The neutrophil leucocytosis which followed total abdominal hysterectomy was accompanied by a fall in the intraneutrophilic activities of all three granule-associated proteins. Intraneutrophilic lysozyme activity and intraneutrophilic vitamin B12 binding capacity were maximally reduced within 4 h of surgery and fell to 62 +/- 13% (mean +/- SEM) and 63 +/- 9% of their preoperative levels, respectively. This contrasted with the activity of intraneutrophilic beta-glucuronidase which was not maximally reduced until 24 h post-surgery when a fall to 80 +/- 6% of the preoperative level was observed. By the fifth postoperative day activities of the three intraneutrophilic granule proteins were increasing and approaching those observed preoperatively. Serum lysozyme and plasma unsaturated vitamin B12 binding capacity (UBBC) rose steadily following surgery and were significantly elevated by the fifth postoperative day. It is suggested that activation and in vivo degranulation of circulating neutrophils may be responsible for these changes in activity of neutrophil granule proteins following surgery.

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“…6 Surgery did not change the phagocytic capacity of PMNs from patients with AM in the presence of normal plasma, supporting the results of others that the intrinsic phagocytic capacity of PMNs is not affected by surgery. [7][8][9] However, in the presence of autologous plasma, PMN phagocytosis of patients with AM decreased by 30% within 2 hours after surgery. This decrease in phagocytic capacity of PMNs correlated with the postoperative decrease in plasma C3 and IgG levels, two opsonins essential for optimal ingestion of bacteria, 7,10,11 suggesting that the decreased phagocytosis after abdominal surgery was caused by a decrease of circulating plasma opsonins, as found by others.…”

Section: Discussionmentioning

confidence: 99%

Impaired leukocyte phagocytosis in patients undergoing hemihepatectomy for liver metastases

Wiezer¹,

Meijer²,

Wallast-Groenewoud³

et al. 1999

Liver Transpl

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Patients undergoing partial hepatectomy have an increased susceptibility to infection. To investigate whether this increased risk is related to impaired leukocyte function, we studied polymorphonuclear leukocyte (PMN) phagocytosis in patients undergoing a hemihepatectomy because of liver metastasis (LM, n ‫؍‬ 11) and in patients undergoing major abdominal surgery because of abdominal malignancy (AM, n ‫؍‬ 8). Eight healthy volunteers (HVs) served as controls. Leukocyte suspensions were incubated with fluorescein isothiocyanate-labeled Staphylococcus aureus, and phagocytosis was measured by flow cytometry. Preoperative PMN phagocytosis, in the presence of autologous plasma, was significantly less in patients with LM compared with patients with AM or HVs. This impaired phagocytosis was potentially restored in the presence of normal plasma.The decreased phagocytic capacity of PMNs from patients with LM was not related to levels of known plasma opsonins or phenotypic changes of PMNs. Rather, it was related to a deficiency of unidentified plasma factors. After surgery, the phagocytic capacity of PMNs of patients with AM decreased by approximately 30%, which correlated with decreasing levels of immunoglobulin G and C3. In conclusion, patients with LM had a decreased PMN phagocytic capacity before surgery. This impairment in phagocytosis disappeared 1 week after surgery. We propose that the presence of LM leads to a deficiency of factor(s) in the blood that impairs PMN phagocytic capacity.Copyright 1999 by the American Association for the Study of Liver Diseases P artial hepatectomy is the first choice of treatment for patients with liver metastasis (LM) of colorectal cancer. During the last decade, major advances in anesthetic and surgical techniques, as well as improvement in postoperative care, have significantly reduced mortality and morbidity after liver resection. Nevertheless, extensive liver resection is still associated with a high incidence of infectious complications. [1][2][3][4] Elimination of pathogenic microorganisms by the host immune system occurs mainly through phagocytosis by polymorphonuclear leukocytes (PMNs). By virtue of this capacity, PMNs constitute the initial cellular barrier against infection. Therefore, infections occurring in the immediate postoperative period after partial hepatectomy may be related to a decreased phagocytic capacity of these cells. To investigate this idea, we evaluated the ex vivo phagocytosis of bacteria by PMNs from patients before and after a hemihepatectomy for metastatic colorectal carcinoma. As controls, patients undergoing abdominal surgery because of malignancy, as well as healthy volunteers (HVs), were studied. Materials and Methods PatientsEleven patients undergoing (extended) hemihepatectomy (resection of Ն three liver segments) for LM of colorectal carcinoma (9 men and 2 women; mean age, 60.8 Ϯ 2.5 years) and 8 patients undergoing resection of colorectal cancer, without liver metastases (AM; 6 men and 2 women; mean age, 61.8 Ϯ 3.7 years) were included. Eight...

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Effects of surgery on neutrophil granulocyte function

Cited by 56 publications

References 18 publications

Predictive value of skin testing, neutrophil migration and C‐reactive protein for postoperative infections in cardiopulmonary bypass patients

Predictive value of skin testing, neutrophil migration and C‐reactive protein for postoperative infections in cardiopulmonary bypass patients

The effects of surgery on the activity of neutrophil granule proteins

Impaired leukocyte phagocytosis in patients undergoing hemihepatectomy for liver metastases

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