Smoking, Gender, and Overweight Are Important Influencing Factors on Monocytic HLA-DR before and after Major Cancer Surgery

Abstract

Background Monocytic human leukocyte antigen D related (mHLA-DR) is essential for antigen-presentation. Downregulation of mHLA-DR emerged as a general biomarker of impaired immunity seen in patients with sepsis and pneumonia and after major surgery. Influencing factors of mHLA-DR such as age, overweight, diabetes, smoking, and gender remain unclear. Methods We analyzed 20 patients after esophageal or pancreatic resection of a prospective, randomized, placebo-controlled, double-blind trial (placebo group). mHLA-DR was determined from day of surgery (od) until postoperative day (pod) 5. Statistical analyses were performed using multivariate generalized estimating equation analyses (GEE), nonparametric multivariate analysis of longitudinal data, and univariate post hoc nonparametric Mann–Whitney tests. Results In GEE, smoking and gender were confirmed as significant influencing factors over time. Univariate analyses of mHLA-DR between smokers and nonsmokers showed lower preoperative levels (p = 0.010) and a trend towards lower levels on pod5 (p = 0.056) in smokers. Lower mHLA-DR was seen in men on pod3 (p = 0.038) and on pod5 (p = 0.026). Overweight patients (BMI > 25 kg/m2) had lower levels of mHLA-DR on pod3 (p = 0.039) and pod4 (p = 0.047). Conclusion Smoking is an important influencing factor on pre- and postoperative immune function while postoperative immune function was influenced by gender and overweight. Clinical trial registered with ISRCTN27114642.

Excessive intravenous crystalloid infusion after video-assisted thoracoscopic surgery lobectomy is associated with postoperative pneumonia

“…The result of the present study corresponded with the earlier studies, which reported that overweight or obese patients have an increased risk of POP [15–17]. Obese patients often have reduced lung volume, altered ventilation pattern, decreased immune function, and comorbid conditions, which are risk factors for intra- and postoperative complications [16–18]. Overweight and obesity are spreading worldwide, and thoracic surgeons will encounter more overweight patients in need of surgery in the future [19].…”

Case Report: Interferon-γ Restores Monocytic Human Leukocyte Antigen Receptor (mHLA-DR) in Severe COVID-19 With Acquired Immunosuppression Syndrome

“…Although not routinely incorporated in current sepsis care guidelines despite existence of functional cellular markers (13)(14)(15), the detection of an acquired immunosuppression syndrome (AIS) seems to be essential to tailor the immune therapy (16). Reduced mHLA-DR expression impairs the T-cells activation, which increases the likelihood of secondary infections by five times and is per-se associated with endotoxin tolerance (17,18). Measurements beginning on day 17 of the illness revealed that merely 22% to 28% of CD14+ monocytes expressed HLA-DR.…”

<p>Risk factors of postoperative pulmonary complications after minimally invasive anatomic resection for lung cancer</p>

“…Obese patients often have reduced lung volume, altered ventilation pattern, and comorbid conditions, which are risk factors for intra-and postoperative complications 13,14. Being overweight is an important influencing factor on pre- and postoperative immune function 15. Additionally, an elevated BMI in patients will lead to increased difficulty during surgery and prolonged operative times 16.…”