Immunodepression in the Surgical Patient and Increased Susceptibility to Infection

Angele, Martin K.; Faist, Eugen

doi:10.1007/0-306-47664-9_43

Cited by 90 publications

(129 citation statements)

References 52 publications

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“…The situation is explained by an increased population of patients receiving anti-cancer chemotherapy, immunosuppressive medicine after organ transplantation and invasive surgical procedures. These patients are classified as a high-risk group susceptible to sepsis (1)(2)(3)(4). The death rate of GNB infection patients will be significant decreased if a prophylaxis therapy is clinically available.…”

Section: Introductionmentioning

confidence: 99%

Protection of Immuno-Compromised Mice from Lethal Infection of Klebsiella Pneumonia by rAAV2-BPI23-Fcγ1 Gene Transfer

Kong

et al. 2008

Cell Mol Immunol

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Section: Introductionmentioning

confidence: 99%

Protection of Immuno-Compromised Mice from Lethal Infection of Klebsiella Pneumonia by rAAV2-BPI23-Fcγ1 Gene Transfer

Kong

et al. 2008

Cell Mol Immunol

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“…3,4 In recent years, our knowledge of the mechanisms of LPS tolerance and macrophage desensitization by repeated LPS exposure has increased considerably as a result of novel insights into the LPS signalling pathways. LPS signal transduction is initiated by Toll-like receptor 4 (TLR-4), 5,6 which belongs to the group of pattern recognition receptors.…”

Section: Introductionmentioning

confidence: 99%

Differential effects of CpG‐DNA in Toll‐like receptor‐2/‐4/‐9 tolerance and cross‐tolerance

et al. 2005

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Summary Lipopolysaccharide (LPS) tolerance is a state of refractoriness towards a second stimulation by LPS after a preceding stimulation. LPS is recognized by Toll‐like receptor‐4 (TLR‐4), which belongs to a group of pattern recognition receptors mediating activation of innate immunity by microbial components. To date, it is not known in detail to what extent other TLR‐dependent stimuli also induce tolerance and whether preceding and challenging stimuli are interchangeable. We have examined tolerance induction in detail for lipoteichoic acid (LTA), LPS and CpG‐DNA, which are recognized by TLR‐2, ‐4 and ‐9, respectively. In RAW264·7 macrophages, all three stimuli induced tolerance towards a subsequent challenge with the same stimulus used for priming, as well as cross‐tolerance towards subsequent challenge with other stimuli signalling via different TLRs. However, whereas LPS/LTA cross‐tolerance was also functional in an in vivo model of galactosamine (GalN)‐primed liver damage, pretreatment with CpG only protected against GalN/CpG challenge and failed to induce cross‐tolerance for LPS and LTA. CpG‐DNA pretreatment even enhanced tumour necrosis factor (TNF)‐α production and liver damage upon subsequent challenge with LPS or LTA. Stimulation with CpG‐DNA resulted in a peculiar sensitization for interferon (IFN)‐γ secretion. The data indicate that, in contrast to in vitro macrophage desensitization, the in vivo consequences of repeated TLR stimulation greatly differ amongst different TLR ligands.

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“…Surgery has long been known to suppress immune function [1][2][3][4][5][6]. Human Leukocyte Antigen-DR (HLA-DR), one of the Major Histocompatibility Complex class-II proteins expressed on monocytes, macrophages and dendritic cells, is a crucial molecule for the presentation of antigen to lymphocytes and the initiation of adaptive immune responses [7,8].…”

mentioning

confidence: 99%

HLA‐DR expression and differential trafficking of monocyte subsets following low to intermediate risk surgery*

et al. 2009

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SummaryReduced HLA-DR expression on monocytes has been suggested as a predictive marker of immunosuppression following very high risk surgery, but there are few reports in lower risk surgery. In 32 patients undergoing low to intermediate risk surgery, blood samples were analysed by flow cytometry for HLA-DR expression and numbers in both CD14 high and CD14 low CD16+ monocyte subsets. The numbers of CD14high monocytes increased at 24 h (mean (SD), 5.0 (2.2) vs 7.6 (3.9) · 10 5 cells.ml )1 ; p < 0.01) while CD14 low CD16+ monocytes decreased (0.68 (0.36) vs 0.44 (0.36) · 10 5 cells.ml; p < 0.01). HLA-DR expression was significantly reduced in both subsets by 24 h (mean (SD) fluorescent intensity 440 (310) vs 160 (130) for CD14 high and 1000 (410) vs 560 (380) for CD14 low CD16+ subsets; p < 0.01). This reduction of monocyte HLA-DR expression 24 h following lower risk surgery raises questions about the purported clinical utility of this biomarker as an early predictor of postoperative complications. Our results also suggest that surgery induces significant trafficking (i.e. mobilisation, margination and extravasation) of monocyte subsets, and that monocyte HLA-DR depression is the result of a down-regulatory phenomenon (decreased protein expression on each cell) rather than the differential trafficking of monocyte subsets.

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Immunodepression in the Surgical Patient and Increased Susceptibility to Infection

Cited by 90 publications

References 52 publications

Protection of Immuno-Compromised Mice from Lethal Infection of Klebsiella Pneumonia by rAAV2-BPI23-Fcγ1 Gene Transfer

Protection of Immuno-Compromised Mice from Lethal Infection of Klebsiella Pneumonia by rAAV2-BPI23-Fcγ1 Gene Transfer

Differential effects of CpG‐DNA in Toll‐like receptor‐2/‐4/‐9 tolerance and cross‐tolerance

HLA‐DR expression and differential trafficking of monocyte subsets following low to intermediate risk surgery*

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