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Complex perioperative immuno-dysfunction in patients with renal cell carcinoma
M Böhm1, A Ittenson, C Philipp
1Department of Urology, Institute of Experimental Internal Medicine, Otto-von-Guericke-University, Magdeburg, Germany.
The Journal of Urology
|August 8, 2001
Summary
Patients with renal cell carcinoma exhibit immune dysfunction. Surgery for kidney cancer causes significant perioperative immune changes, suggesting a need for immunomodulation strategies.
Area of Science:
- Immunology
- Oncology
- Nephrology
Background:
- Renal cell carcinoma (RCC) is associated with immune system impairment.
- Understanding perioperative immune changes in RCC patients is crucial for immunotherapy development.
Purpose of the Study:
- To investigate perioperative changes in immune parameters in patients with renal cell carcinoma.
- To compare immune responses following tumor nephrectomy, open renal surgery, and extracorporeal shock wave lithotripsy (ESWL).
Main Methods:
- Measured cellular and humoral immunity markers, including differential blood counts, T cell, B cell, and monocyte markers.
- Assessed activation markers (CD25, CD26, HLA-DR) and cytokines (IL-1 receptor antagonist, IL-2, soluble IL-2 receptor, IL-6, IL-10, TGF-beta).
- Compared immune profiles in 37 RCC patients undergoing tumor nephrectomy, 20 undergoing open renal surgery, 24 undergoing ESWL, and 39 controls.
Main Results:
- ESWL and controls showed minimal immune changes.
- Open renal surgery led to increased leukocytes and granulocytes, with decreased T cells postoperatively.
- Tumor nephrectomy patients exhibited more pronounced immunosuppressive changes, including elevated IL-6 and IL-10, compared to non-malignant renal surgery patients.
Conclusions:
- Patients with renal cell carcinoma experience selective immune dysfunction.
- Perioperative immunomodulation may be a rational therapeutic approach for RCC patients.