Surgery, Trauma and Immune Suppression Evolving the Mechanism

Abstract

A major surgical procedure can impair the delayed hypersensitivity response. This impairment is associated with suppressor cell activity that can alter either afferent or efferent responses. Using the third party mixed leukocyte culture to define cell types involved, major immune impairment was seen with the combination of both nonadherent and plastic adherent cells, suggesting that a T cell-macrophage interaction is required. A serum factor(s) is present in operated mice that can impair mixed leukocyte culture reactivity. A serum factor(s) in an adoptive transfer experiment is also capable of enhancing primary tumor growth. A unifying hypothesis, based predominantly on data from the current literature, is presented in an attempt to elucidate the mechanism by which all forms of major trauma are associated in some patients with "paradoxical" immune suppression.

Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

“…Perioperative complications can lead to a modulation of the immune state, decrease in tumor surveillance, and possibly increased risk of disease recurrence and disease-specific death. [12][13][14][15] To the best of our knowledge, the current study is the first to examine the association between the occurrence of a postoperative complication and long-term outcomes among patients undergoing hepatic resection for ICC. The current study is important because the data have demonstrated that postoperative complications were independently associated with both RFS and OS.…”

“…Laparotomy itself can initiate a systemic inflammatory response characterized by high levels of inflammatory cytokines and C-reactive protein. 13,14,34 Colacchio et al reported that perioperative stress can depress natural killer cell cytotoxicity and increase tumor burden. 35 For example, in an animal model, these investigators compared animals who did and did not have surgical stress.…”

“…[12][13][14] In turn, perioperative complications may exacerbate this inflammatory response and induce a state of immunosuppression. 14 This state of immunosuppression may decrease tumor surveillance and lead to detrimental effects, including worse long-term oncological outcomes. 15 Some investigators have even suggested that hepatectomy itself is an immunosuppressive event that results in significant Kupffer cell and T-cell dysfunction.…”

Oral Administration of Immunopotentiator from Pantoea agglomerans 1 (IP-PA1) Improves the Survival of B16 Melanoma-Inoculated Model Mice

“…The majority of tumor cells can potentially inhibit host immunity through various mechanisms such as the production of immunosuppressive IL-10 [9]. In addition, conventional chemotherapy [44], radiotherapy [21], and surgery [4,24] frequently suppress host immunity; therefore, cancer patients are generally, immunologically suppressed.…”

Phase IB study on prevention of surgery‐induced immunodeficiency with preoperative administration of low‐dose subcutaneous interleukin‐2 in gastric cancer patients

“…In fact, either the total [3,4] and the T-cell [5,6] lymphocytopenia represents a prognostic factor for a poor survival in cancer patients, independent by other well known clinical prognostic factors such as performance status, disease extent, and weight loss [4,7]. Moreover, although radical surgery represents the only curative treatment, the biological response to major surgical trauma induces a temporary immunosuppression, likely due to the release of polipeptidic mediators having immunosuppressive activity [8] and to the direct inhibition of circulating lymphocytes by monocytes/macrophages [9] induced by laparotomic surgical stress [10].…”