Postoperative immunosuppression markers and the occurrence of sepsis in patients with benign and malignant disease

Ivić, Dubravka; Wagner, Jasenka; Ivić, Josip; Dobrošević, Blaženka; Turina, Ivana; Kralik, Kristina; Barbić, Jerko

doi:10.1007/s00508-014-0613-6

Cited by 5 publications

(3 citation statements)

References 42 publications

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“…• Anti-inflammatory • May be susceptible to TA [21] • Stimulates inhibitory NK and invariant T [32] • Predict immunosuppression and systemic inflammation [33] GR, glucocorticoid receptor; GC, glucocorticoid; TR, transrepression; GR-mediated inhibition of gene expression through interaction with transcription factors (e.g. AP-1 and NF-jB); TA, transactivation; GR-mediated activation of anti-inflammatory genes through interaction with glucocorticoid response elements (GLE) within DNA; NK cells, natural killer cells; Th1; T helper cells (Type 1); Th2, T helper cells (Type 2); mRNA, messenger RNA; MAPK, mitogen-activated protein kinase; SIRS, systemic inflammatory response syndrome.…”

Section: Il-1bmentioning

confidence: 99%

The early in‐vivo effects of a single anti‐emetic dose of dexamethasone on innate immune cell gene expression and activation in healthy volunteers

et al. 2018

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Dexamethasone is often administered to surgical patients for anti-emetic prophylaxis. This study examined the early (up to 24 h) in-vivo effects of dexamethasone (8 mg) to demonstrate the magnitude and temporal nature of changes on circulating peripheral blood mononuclear cell gene expression and activation in 10 healthy male volunteers. Blood samples were drawn at baseline, 2 h, 4 h and 24 h. Gene expression was measured using quantitative real-time polymerase chain reaction. Cytokine expression was measured using multiplex immuno-assays. Innate immune cell phenotypes were examined with flow cytometry. Dexamethasone resulted in rapid transient changes in immunophilin (p = 0.0247), plasminogen activator inhibitor-1 (p = 0.0004), forkhead box P3 (p = 0.0068) and dual specific phosphatase-1 (p = 0.0157) gene expression at 4 h compared with pre-dexamethasone. Plasma interleukin-10 levels increased within 2 h (p = 0.0071) and returned to baseline at 24 h. Reductions in classical (p = 0.0009) and intermediate monocytes (p = 0.0178) and dendritic cells (p = 0.0012) were followed by increases in the level of these populations at 24 h compared with pre-dexamethasone (classical monocytes p = 0.0073, intermediate monocytes p = 0.0271, dendritic cells p = 0.0142). There was a profound reduction in the mean fluorescence intensity of the maturation marker, human histocompatibility leucocyte antigen, at 24 h in all monocyte subsets (p = 0.0002 for classical and non-classical monocytes, p = 0.0001 for intermediate monocytes) and dendritic cells (p = 0.0001). This study confirms rapid transient effects of 8 mg dexamethasone on innate immune cells with the potential to alter the inflammatory response to surgery and provides support for the hypothesis that intra-operative administration may be both immunosuppressive and immune-activating in the immediate peri-operative period.

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Section: Il-1bmentioning

confidence: 99%

The early in‐vivo effects of a single anti‐emetic dose of dexamethasone on innate immune cell gene expression and activation in healthy volunteers

et al. 2018

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“…While the underlying mechanism of this phenomenon is still unclear, some reports suggested that damage of the immune system caused by using chemotherapy might be a key point, [9] and multiple patient and animal experiments had confirmed the changes [11–13]. However, studies focused on other localized changes, such as intestinal tissue damage caused by chemo drugs, were scanty.…”

Section: Discussionmentioning

confidence: 99%

The influence of neoadjuvant chemotherapy on gastric cancer patients’ postoperative infectious complications: What is the negative role played by the intestinal barrier dysfunction?

et al. 2017

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Evidence has shown that neoadjuvant chemotherapy (NACT) is correlated with patients’ overall postoperative complications. But investigations on relationship between NACT and postoperative infectious complications, which is closely linked to intestinal barrier damage, were scanty. Accordingly, 90 patients with advanced gastric cancer were included in this study. The differences in postoperative infectious complications were determined between NACT group in which patients received NACT before surgery and SURG group in which received surgical treatment immediately after diagnosis. The damage of mechanical structure of intestinal barrier was assessed by hematoxylin and eosin staining, transmission electron microscopy, and immunohistochemistry. Mucosal microbiota changes were determined by using a 16S rRNA gene sequencing approach. Results showed that the incidence of postoperative infectious complications were significantly higher in the NACT group. Tight junctions were disrupted, and claudin-1, ZO-1 and occludin were down-regulated in patients with infectious complications in overall compared with those without. And similarly, the patients in the NACT group also showed damaged intestinal barrier compared with those in SURG group. Besides, the total diversity of mucosal related bacteria was decreased and relative abundance of some probiotics, such as Bifidobacterium, Faecalibacterium and Ruminococcus, was reduced in the NACT group as well. In conclusion, our study identifies a higher incidence of postoperative infection in gastric cancer patients who underwent NACT treatment, and these changes might be caused by a significant damage in the intestinal barrier as well as reduced probiotics.

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“…Sepsis in oncologic patients is a serious complica tion in the course of primary treatment. Surgery, often an extensive one, involves opening of the digestive tract, urinary tract, anastomosis of the colon, use of vascular lines, catheters in the bladder, parenteral nutri tion, stay in the ICU, immunocompromised immune systems, and favours systemic infections (Encina et al 2016;Alkhamis et al, 2014;Smit et al, 2016;Mahdi et al, 2014). Generalized infections in cancer patients are burdened with high mortality; therefore, time is one of the important factors in their diagnosis and treatment (NamendysSilva et al, 2010;Rosolem et al, 2012).…”

mentioning

confidence: 99%

Rapid Detection of Bloodstream Pathogens in Oncologic Patients with a FilmArray Multiplex PCR Assay: a Comparison with Culture Methods

Szymankiewicz¹,

Nakonowska²

2018

Polish Journal of Microbiology

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The results of the FilmArray® Blood Culture Identification Panel (BCID) (BioFire Diagnostics) and the culture with susceptibility testing of 70 positive blood cultures from oncologic patients were compared. The multiplex PCR assay (BCID) identified 81 of the 83 isolates (97.6%), covered by the panel. The panel produced results in significantly shorter time than standard identification methods, when counted from receiving positive blood cultures bottles to the final results. It is an accurate method for the rapid identification of pathogens and resistance genes from blood culture in oncologic patients.

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Postoperative immunosuppression markers and the occurrence of sepsis in patients with benign and malignant disease

Abstract: Our results suggest that the immunosuppressive effect of surgery and the presence of a malignant disease may contribute to a higher risk of postoperative sepsis. Preoperative CRP levels may be a reliable predictor of sepsis in oncological patients.

Cited by 5 publications

References 42 publications

The early in‐vivo effects of a single anti‐emetic dose of dexamethasone on innate immune cell gene expression and activation in healthy volunteers

The early in‐vivo effects of a single anti‐emetic dose of dexamethasone on innate immune cell gene expression and activation in healthy volunteers

The influence of neoadjuvant chemotherapy on gastric cancer patients’ postoperative infectious complications: What is the negative role played by the intestinal barrier dysfunction?

Rapid Detection of Bloodstream Pathogens in Oncologic Patients with a FilmArray Multiplex PCR Assay: a Comparison with Culture Methods

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