Lymphocyte responses following open and minimally invasive thoracic surgery

Ha, Leaver; Craig,; Pl, Yap; Ws, Walker

doi:10.1046/j.1365-2362.2000.00622.x

Cited by 136 publications

(102 citation statements)

References 36 publications

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“…Previous studies demonstrated that T helper cells decreased and T suppressor cells increased significantly as early as 1 day after surgery [22][23][24] . Many subsequent studies also confirmed that surgery for patients with lung cancer [25] , esophageal cancer [26] , gastric cancer [27,28] and colorectal cancer [29,30] induced immediate severe immunosuppression. For cancer patients, an important function adversely affected by this immunosuppression is the anti-tumor response itself.…”

Section: Discussionmentioning

confidence: 85%

Perioperative cimetidine administration promotes peripheral blood lymphocytes and tumor infiltrating lymphocytes in patients with gastrointestinal cancer: Results of a randomized controlled clinical trial

Cai¹,

Bai²,

Yuan³

et al. 2004

WJG

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AIM:To study the effects of perioperative administration of cimetidine (CIM) on peripheral blood lymphocytes, natural killer (NK) cells and tumor infiltrating lymphocytes (TIL) in patients with gastrointestinal (GI) cancer. METHODS:Forty-nine GI cancer patients were randomized into treatment group, who took CIM in perioperative period, and control group, who did not take the drug. The treatment was initiated 7 days before operation and continued for 10 days after surgery. At baseline examination before operation, on the 2nd and 10th postoperative days, total T lymphocytes, T helper cells, T suppressor cells, and NK cells in peripheral blood were measured respectively by immunocytochemical method using mouse-anti human CD 3 , CD 4 , CD 8 and CD 57 monoclonal antibodies. Blood samples from 20 healthy volunteers were treated in the same way as normal controls. Surgical specimens were examined during routine histopathological evaluation for the presence of TIL in tumor margin. Immunohistochemical study was performed to measure the proportion of T and B lymphocytes in TIL population. T and B lymphocytes were detected respectively using mouse-anti-human CD 3 and CD 20 monoclonal antibodies. RESULTS:In comparison with normal controls, both the treatment and control groups had decreased T cells, T helper cells and NK cells at baseline. In control group, total T cells, T helper cells and NK cells declined continuously with the disease progression and the decrease became more obvious after operation. From baseline to the 2nd postoperative day, the proportion of total T cells, T helper cells, and NK cells went down from 60.5±4.6% to 56.2±3.8%, 33.4±3.7% to 28.1±3.4%, and 15.0±2.8% to 14.2±2.2%, respectively. On the other hand, there were significant improvements in these parameters after CIM treatment. On the 10th postoperative day, the treatment group had significantly higher percentages of total T cells, T helper cells and NK cells than control group. Moreover, CIM treatment also boosted TIL response, as was reflected by findings that 68% (17/25) of the patients in treatment group had significant TIL responses and only 25% (6/24) of the cases had discernible TIL responses (P<0.01). CONCLUSION:Perioperative application of CIM to GI cancer patients could help restore the diminished cellular immunity induced by tumor burden and surgical maneuver. The drug could also boost TIL responses to tumor. These effects suggest that the drug be used as an immunomodulator for GI cancer patients.

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Section: Discussionmentioning

confidence: 85%

Perioperative cimetidine administration promotes peripheral blood lymphocytes and tumor infiltrating lymphocytes in patients with gastrointestinal cancer: Results of a randomized controlled clinical trial

Cai¹,

Bai²,

Yuan³

et al. 2004

WJG

View full text Add to dashboard Cite

show abstract

“…The numbers of white blood cells in the circulating blood increases while circulating lymphocyte numbers are reduced. The extent and duration of this phenomenon is related to the magnitude of the previous surgical procedure [33]. The postoperative impairment of T cell function with a shift to regulatory T lymphocytes as well as a suppressed NK cell cytotoxicity supports the immune suppressive effect [34].…”

Section: Discussionmentioning

confidence: 99%

Surgical Trauma and Postoperative Immune Dysfunction

et al. 2012

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Background: In postoperative sepsis, mortality is increased due to the surgically induced immune dysfunction. Further causes of this traumatic effect on the immune system include burn injuries and polytrauma, as well as endogenous traumata like stroke. Several animal models have been defined to analyse the characteristics of trauma-induced immune suppression. This article will correlate our results from animal studies and clinical observations with the recent literature on postoperative immune suppression. Methods: The previously described model of surgically induced immune dysfunction (SID) was performed in mice by laparotomy and manipulation of the small intestine in the antegrade direction. Blood samples were collected 6 and 72 h following SID to analyse the white blood cell count and corticosterone levels. To assess the postoperative immune status in humans, we analysed expression of HLA-DR on monocytes of 118 patients by flow cytometry prior to and 24, 48 and 72 h after surgery. Results: The postoperative immune suppression in our SID model is characterised by lymphocytopenia and significantly increased corticosterone levels in mice dependent on the degree of surgical trauma. This is comparable to the postoperative situation in humans: major and especially long-lasting surgery results in a significantly reduced expression of HLA-DR on circulating monocytes. Previous studies describe a similar situation following burn injury and endogenous trauma, i.e. stroke. Conclusions: We suggest the completion of our previously published sepsis classification due to the immune status at the onset of sepsis: type A as the spontaneously acquired sepsis and type B as sepsis in trauma-induced pre-existing immune suppression.

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“…Postoperative proinflammatory cytokine levels are lower, and T (CD4) cells, as well as natural killer cells, are less suppressed after VATS compared with their open counterparts (12,13). Also, patients undergoing VATS require significantly less postoperative parenteral narcotics than patients undergoing procedures using the open techniques (12).…”

Section: Vats For Pneumothoraxmentioning

confidence: 99%