Multi-dose parecoxib provides an immunoprotective effect by balancing T helper 1 (Th1), Th2, Th17 and regulatory T cytokines following laparoscopy in patients with cervical cancer

Abstract

Analgesic treatment with anti‑inflammatory drugs may aid the prevention of postoperative pain and the attenuation of the postoperative immune inflammatory response. The current study presents a randomized, double‑blind controlled study, which was performed to investigate the levels of Th1, Th2, Th17 and Treg cytokines, including interleukin (IL)‑2, interferon (IFN)‑γ, IL‑4, IL‑10, IL‑17, IL‑23 and transforming growth factor (TGF)‑β in the peripheral blood of patients with cervical cancer following laparoscopy. The effects of perioperative multi‑dose parecoxib on postoperative immune function was evaluated. A total of 80 patients with cervical cancer (stage IB/IIA, ASA I‑III, aged 18‑65 years) that were scheduled for laparoscopy were randomly assigned into either the parecoxib (I; n=40) or control (II; n=40) groups. Group I received 40 mg parecoxib 30 min prior to surgery and then every 12 h subsequent to surgery for 60 h, and group II received normal saline at the corresponding time points. Intravenous tramadol (100 mg) was prescribed for pain relief as required. The mRNA and protein expression levels of cytokines in the peripheral blood were detected by quantitative polymerase chain reaction and ELISA. Pain visual analog scales (VAS) and incidence, analgesic relief, adverse events and the length of hospital stay were recorded. It was demonstrated that the mRNA and protein levels of IL‑2, IFN‑γ and IL‑17 in the two groups were reduced subsequent to surgery, while mRNA and protein expression levels of IL‑4, IL‑10 and TGF‑β were enhanced. Administration of multi‑dose parecoxib may diminish the increase in postoperative IL‑2, IFN‑γ and IL‑17 levels, and suppress the excessive production of IL‑4, IL‑10 and TGF‑β. This effect is accompanied by lower VAS scores, pain incidence, postoperative nausea/vomiting and infections. In conclusion, perioperative multi‑dose parecoxib was able to alleviate postoperative pain and ameliorate surgery‑induced immune suppression by balancing Th1, Th2, Th17 and Treg cytokines following laparoscopy in patients with cervical cancer. The current study provides support to the hypothesis that parecoxib may be a more effective therapeutic strategy than the currently available options, for postoperative pain and immune function management of patients with cancer.

Expression of Th1- Th2- and Th17-associated cytokines in laryngeal carcinoma

“…The tumor classification of the patients in the present study was consistent with the literature reported previously (22). Accumulating evidence has altered the traditional paradigm of Th1/Th2 cytokine classification to include two novel subsets of CD4 + T cells, Th17 and Treg cells, which are characterized by their distinct cytokine profiles (34)(35)(36). Th17 and Treg cells predominantly produce IL-17 and TGFβ family cytokines, respectively (37).…”

29 immune-related genes pairs signature predict the prognosis of cervical cancer patients

“…Th1 and Th2 may be involved in the pathogenesis and growth of cervical cancer. Th1 may be the target of predicting chemotherapy response of advanced cervical cancer [47][48][49][50] , while other pathways are classical signal pathways related to cancer. Immune cytokines play an important role in cervical lesions.…”

<p>Cervical Cancer: Emerging Immune Landscape and Treatment</p>

“…Th1, Th2, Th17 and Tregs produce positive or negative effects in the maintenance of normal immune function by secreting various cytokines: interleukin-2 (IL-2) and interferon-γ (IFN-γ), the principal cytokines delivered by Th1cells, IL-12, a key cytokine involved in inducing and maintaining Th1cells and the IFN-γ responses, and IL-10, a potent modulator of cell-mediated immune responses secreted by Th2. 26 IL-17 is a recently identified pro-inflammatory cytokine secreted by Th17 cells. According to a previous report, IL-17 promotes angiogenesis and cell proliferation and invasion in CC.…”