Natural Killer Cell Activity in Patients Undergoing Upper Abdominal Surgery: Relationship to the Endocrine Stress Response

Abstract

Natural killer (NK) cell activity and the endocrine response during and after parietal cell vagotomy were studied in two groups of patients receiving either epidural analgesia extending from S5 to Th4 + general anaesthesia (Group I), or general anaesthesia (Group II). NK cell activity of unseparated mononuclear cells in peripheral blood was measured against K-562 target cells in a 51Cr-release assay. NK cell activity increased in the same way in both groups in relation to premedication, anaesthesia and surgery (P less than 0.01). Postoperatively, the activity fell significantly on the first day (P less than 0.01), but returned to preoperative levels on day 3 (Group I) and day 5 (Group II). The endocrine response measured, except for adrenaline and prolactin, differed between Group I and II. In Group I, plasma noradrenaline and serum cortisol increased insignificantly throughout the observed period--compared to the preoperative level--whereas a significant increase in both hormones was found in Group II during surgery and in the postoperative period. A significant increase in plasma adrenaline and serum prolactin was found in both groups during anaesthesia and surgery. The findings indicate that NK cell activity during upper abdominal surgery is modified in almost the same way during two different anaesthetic techniques, one of which partly seemed to block the endocrine surgical stress response. The fluctuations in NK cell activity were not correlated to the changes measured in hormone concentrations.

Influence of General Anesthesia with Isoflurane Following Propofol-Induction on Natural Killer Cell Cytotoxic Activities of Peripheral Blood Lymphocytes in Dogs

“…Analysis of the data revealed that NK cytotoxic activity in dogs was significantly lower 24 hr after anesthesia. These findings agree with the results of a human study [14]. However, in that report [14], surgical procedures had been performed in addition to the anesthesia.…”

“…These findings agree with the results of a human study [14]. However, in that report [14], surgical procedures had been performed in addition to the anesthesia. As our finding is based on the use of anesthesia without surgery, the combination of anesthesia and operation Samples were obtained before anesthesia (baseline) and 24, 120 and 192 hr after the anesthesia, and anesthesia then was induced with propofol and maintained with isoflurane for 3 hr; blood samples were obtained from the control dogs at the same time points as for the anesthetized dogs.…”

“…In contrast, NK cytotoxic activity then returned to preoperative values by 5 days after anesthesia for surgery in humans [14]. However, surgical stress and anesthesia protocol do not carry out coincidence of the present study, and it might suggest that the effect of anesthesia on NK cytotoxic activity return to baseline values is not related to the existence of surgery.…”

The influence of anaesthetic technique upon the immune response to hysterectomy

“…T helper cells are a subset of T lymphocytes pivotal in augmenting both cell-mediated [3] and humoral immunity [4]. Major surgery causes changes in the immune response which are related to the extent of surgical trauma [5] and the neuroendocrine stress response [6]. In this study we compared the effects of propofol infusion anaesthesia and combined isoflurane anaesthesia on the immune response to abdominal hysterectomy.…”

Profile of Patients with Chemical Injury and Sensitivity

“…A greater number of chemical-specific antibodies has been noted after exposure to building materials in remodeling (21). Suppression of mitogenesis (22) and natural killer cell (NK) function (23) has been described following anesthesia induced by petrochemical agents. Reduced NK function in multiple chemical sensitivity (MCS) patients also has been reported by Heuser (24).…”