T-cell dysfunction in a patient with short bowel syndrome: report of a case

We describe herein the case of a 48-year-old man who underwent emergency massive resection of the small intestine due to strangulated ileus, which led to short bowel syndrome (SBS) as he was left with 7 cm of jejunum and 8 cm of ileum. We evaluated the immune function in this patient, focusing particular attention on T-cell-mediated immunity. Biochemical and nutritional parameters, including minerals and trace elements, indicated that the patient was in relatively good health; however, the proliferative response to mitogen and tumor necrosis factor-alpha production in response to the anti-CD3 monoclonal antibody in peripheral blood lymphocytes (PBL) were impaired compared with age-matched postgastrectomy patients and healthy donors. Moreover, the expression of T-cell receptor (TCR) zeta, which is involved in signal transduction and the subsequent activation of T cells, was downregulated in this patient compared with that in the age-matched postgastrectomy patients and healthy donors. These observations suggest that T-cell function was disturbed in our patient, and that this dysfunction was associated with the decreased expression of TCR zeta molecules.