Th2/Th17 cell associated cytokines found in seroma fluids after breast cancer surgery

Abstract

Purpose The development of a seroma after breast cancer surgery is a common postoperative complication seen after simple mastectomy and axillary surgery. We could recently demonstrate that breast cancer patients undergoing a simple mastectomy with subsequent seroma formation developed a T-helper cell increase within the aspirated fluid measured by flow cytometry. The same study revealed a Th2 and/or a Th17 immune response in peripheral blood and seroma fluid of the same patient. Based on these results and within the same study population, we now analyzed the Th2/Th17 cell associated cytokine content as well as the best known clinical important cytokine IL-6. Methods Multiplex cytokine measurements (IL-4, IL-5, IL-13, IL-10, IL-17, and IL-22) were done on 34 seroma fluids (Sf) after fine needle aspiration of patients who developed a seroma after a simple mastectomy. Serum of the same patient (Sp) and that of healthy volunteers (Sc) were used as controls. Results We found the Sf to be highly cytokine rich. Almost all analyzed cytokines were significantly higher in abundance in the Sf compared to Sp and Sc, especially IL-6, which promotes Th17 differentiation as well as suppresses Th1 differentiation in favor of Th2 development. Conclusion Our Sf cytokine measurements reflect a local immune event. In contrast, former study results on T-helper cell populations in both Sf and Sp tend to demonstrate a systemic immune process.

Elderly and Patients with Large Breast Volume Have an Increased Risk of Seroma Formation after Mastectomy—Results of the SerMa Pilot Study

“…As there are very contradictory data from various studies, a possible association between lymph node removal, or involvement and seroma formation remains unclear [12]. Since other tumor biology characteristics (except grading) also showed no association with seroma development, these data are in line with the previously published results of our group, hypothesizing that seroma formation is rather related to autoimmune/inflammatory processes [9,10] than tumor biological characteristics.…”

“…Consistently across all analyses, higher age has been shown to be a significant risk factor for seroma formation in this cohort. Since aging also leads to changes in the immune system, as shown above, the results presented here support the previously published analyses on a possible influence of an altered immune response on seroma development [9,10]. Further analyses including investigations of seroma fluid and blood, as well as tumor and microenvironment and especially possible changes with an aging immune system, are needed to answer the open immunological questions related to seroma formation.…”

“…Significantly higher numbers of Th2 and Th17 cells were found in the seroma fluid and peripheral blood of the same patients but not in peripheral blood of healthy controls. Furthermore, seroma formation after breast surgery was associated with an inflammatory immune response resulting in an increase of Th2/17 associated cytokines [10]. Based on the cytokine milieu, antigen presentation and expression of costimulatory molecules, activated Th cells differentiate into several functional classes [11].…”

Analysis of retromuscular drain output and postoperative outcomes for heavyweight versus mediumweight polypropylene mesh following open ventral hernia repair

“…Larger pore size mesh has been further correlated with improved integration, marked by increased neovascularization and fibrosis, as well as lower inflammation in multiple pig model studies [ 1 ]. Although the pathophysiology is not fully understood, fluid analysis of postsurgical seromas has demonstrated high levels of Th2/Th17 pathway cytokines [ 19 ], supporting a connection between inflammatory reaction and fluid accumulation. Taking these experimental models together, it could be deduced that denser, less porous mesh material would generate more foreign body reaction and fluid generation, while also demonstrating lower permeability to that fluid.…”

Construction of a Prognostic DNA Damage Repair Gene-related LncRNA Signature by Integrated Analysis of Bulk- and Single-cell RNA Sequencing Data in Lung Adenocarcinoma

“…On the other hand, it can also promote the differentiation and proliferation of tumorassociated macrophages (TAM) and myeloid suppressor cells (MDSCs). In the process of tumor immune response, it plays the role of inhibiting anti-tumor immune response 51,52,53 . B cell in ltration is associated with poor prognosis in renal carcinoma and glioblastoma 54 , suggesting that B cells may promote tumor progression.…”