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Surgical stress induces endotoxin hyporesponsiveness and an early decrease of monocyte mCD14 and HLA-DR expression
T Kawasaki1, M Ogata, C Kawasaki
1Department of Anesthesiology, University of Occupational and Environmental Health, School of Medicine, 1-1-1 Iseigaoka, Yahatanishiku, Kitakyushu, 807-0555, Japan.
Anesthesia and Analgesia
|April 27, 2001
Summary
Major surgery significantly impairs the immune system, decreasing monocyte function and lipopolysaccharide (LPS) responsiveness. These immune alterations during the perioperative period may increase the risk of postoperative complications.
Area of Science:
- Immunology
- Surgical Stress Response
- Host Defense Mechanisms
Background:
- Major surgery is known to cause significant alterations in host-defense mechanisms.
- Understanding the impact of surgical stress on the immune system is crucial for managing postoperative complications.
Purpose of the Study:
- To investigate the effect of surgical stress on the immune system.
- To examine the relationship between perioperative lipopolysaccharide (LPS) hyporesponsiveness and monocyte human leukocyte antigen-DR (HLA-DR) and CD14 expression.
Main Methods:
- Studied 20 patients undergoing partial gastrectomy.
- Monitored monocyte mCD14 and HLA-DR expression perioperatively.
- Assessed lipopolysaccharide (LPS)-induced tumor necrosis factor (TNF)-alpha production ex vivo.
- Measured plasma interleukin-10 concentration.
Main Results:
- Surgical stress rapidly decreased monocyte mCD14 and HLA-DR expression.
- Monocyte mCD14 and HLA-DR expression recovered by postoperative days 1 and 7, respectively.
- LPS responsiveness was suppressed during surgery, returning to baseline by postoperative day 1.
- Plasma interleukin-10 concentration increased post-incision.
Conclusions:
- Surgical stress causes rapid alterations in LPS responsiveness, interleukin-10 levels, and monocyte expression.
- These perioperative immune system changes may contribute to postoperative complications like sepsis and organ failure.