Surgical stress induces a shift in the type-1/type-2 T-helper cell balance, suggesting down-regulation of cell-mediated and up-regulation of antibody-mediated immunity commensurate to the trauma

Decker, D.; Schöndorf, Martin; Bidlingmaier, F.; Hirner, A.; Ruecker, A. A. von

doi:10.1016/s0039-6060(96)80118-8

Cited by 353 publications

(231 citation statements)

References 38 publications

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“…Th1 cells are essential for cellmediated (anti-tumor) immunity, and a shift in the Th1/Th2 balance toward Th1 is beneficial in this regard. However, the ratio of Th1/Th2 decreases after surgery, resulting in a suppressed cell-mediated immunity [4]. Inflammatory cytokines suppress host anti-tumor immunity and lead to tumor growth and metastasis [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of dexmedetomidine on patients undergoing radical gastrectomy

Wang

Liu

et al. 2015

Journal of Surgical Research

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Section: Introductionmentioning

confidence: 99%

Effects of dexmedetomidine on patients undergoing radical gastrectomy

Wang

Liu

et al. 2015

Journal of Surgical Research

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“…Serum concentrations of interleukin 6 (IL-6) were measured by ELISA (A group A vs group B: p=NS) and those of C-reactive protein (CRP) by nephelometry (B group A vs group B: p<0.001). (-7, preoperative day 7; 0A, beginning of surgery; 0B, end of surgery; 1, postoperative day 1; 2, postoperative day 2; 7, postoperative day 7) tive administration of naproxen in knee and spinal surgery [5,6].…”

Section: Discussionmentioning

confidence: 99%

Acute phase response in patients undergoing lumbar spinal surgery: modulation by perioperative treatment with naproxen and famotidine

et al. 2003

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“…Studies assessing the number of circulating lymphocytes of different subtypes have, with rare exception, found no significant differences between open and closed groups [9,15,16]. A randomized cholecystectomy study that indirectly assessed the ratio of Th-1/Th-2 lymphocytes by measuring levels of interferon-g (Th-1) and interleukin-4 (IL-4) (Th-2) that were elaborated by peripheral blood monocytes in vitro, after stimulation, found a significant difference between the laparoscopic and open groups only 2 hours after the operation; all other sampling points yielded similar result between groups [16].…”

Section: Lymphocyte Subpopulation Studiesmentioning

confidence: 99%

“…A randomized cholecystectomy study that indirectly assessed the ratio of Th-1/Th-2 lymphocytes by measuring levels of interferon-g (Th-1) and interleukin-4 (IL-4) (Th-2) that were elaborated by peripheral blood monocytes in vitro, after stimulation, found a significant difference between the laparoscopic and open groups only 2 hours after the operation; all other sampling points yielded similar result between groups [16]. They suggested that this shift in cytokine release was a manifestation of downregulated cell-mediated immunity and upregulated humoral immunity.…”

Section: Lymphocyte Subpopulation Studiesmentioning

confidence: 99%

Immunologic Consequences and Considerations of the Laparoscopic Approach

Feingold¹,

Carter²,

Whelan³

2006

The Sages Manual

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The introduction of advanced laparoscopic operations in the early 1990s led to a close examination of the immunologic consequences of both open and closed surgical methods. This scrutiny has significantly increased our understanding of the impact of surgery on the body and will, it is hoped, lead to new perioperative pharmacologic therapies that will lessen the deleterious immunologic effects of all types of surgery. Before the laparoscopic era, it had been well established that major open surgery is associated with the temporary suppression of a variety of cells that are involved with both innate and specific immunity, including lymphocytes, neutrophils, monocytes, and macrophages. Interactions between cells, chemotaxis, expression of surface antigens, the ability to produce cytokines, and other functions of these immune system cells are negatively influenced by open surgical trauma. Further, the ability to mount a positive response to a delayed-type hypersensitivity (DTH) recall antigen challenge is suppressed after surgery [1][2][3][4][5].The relative contribution of each part of an abdominal procedure (abdominal wall access incision versus intraabdominal dissection and resection) to postsurgical immunosuppression had not been assessed before the advent of advanced laparoscopic methods. The results of recent studies suggest that the method of entry into the abdomen is the most important determinant of postoperative immune function. Minimally invasive methods, for a variety of immune parameters, have been shown to be associated with significantly better preserved function when compared to the equivalent open procedure. Of note, in many cases the differences are small and short lived, on the order of a day, and sometimes less for several variables. For a number of parameters no differences have been noted.It should be realized that the clinical significance, if any exists, of the immune function differences that have been found has not been determined. Better preserved postoperative cell-mediated immune function, in theory, may have an impact on the rate of infections and, possibly, tumor recurrence rates and survival.This chapter reviews the available literature in this area and also speculates on how our improved understanding of surgery's impact on the immune system may lead to novel perioperative treatments in the future.

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Surgical stress induces a shift in the type-1/type-2 T-helper cell balance, suggesting down-regulation of cell-mediated and up-regulation of antibody-mediated immunity commensurate to the trauma

Cited by 353 publications

References 38 publications

Effects of dexmedetomidine on patients undergoing radical gastrectomy

Effects of dexmedetomidine on patients undergoing radical gastrectomy

Acute phase response in patients undergoing lumbar spinal surgery: modulation by perioperative treatment with naproxen and famotidine

Immunologic Consequences and Considerations of the Laparoscopic Approach

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