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Polymorphonuclear leukocyte function and serum opsonic activity in surgical patients
1Second Department of Surgery, Tokyo Medical and Dental University, Japan.
Abstract:
Thirty-six patients who underwent major surgery were studied in order to clarify the perioperative changes in polymorpho - nuclear leukocyte (PMNL) function and serum opsonic activity. In patients without postoperative infection, the PMNL phagocytic-bactericidal capacity and plasma elastase levels significantly increased, while the serum opsonic index remarkably decreased just after surgery, however, all returned to the preoperative levels within 1 or 2 weeks. Conversely, in patients with postoperative infection, the PMNL bactericidal capacity and plasma elastase levels remained at high levels even after 1 or 2 weeks, while the PMNL phagocytic capacity and serum opsonic index substantially decreased after 2 weeks compared with the patients without postoperative infection. Plasma leukotriene B4, which is a potent chemo-attractant for PMNL, noticeably decreased in the patients with postoperative infection on the first postoperative day compared with that in the patients without postoperative infection. Our data suggests that the most important predisposing factors to postoperative infection may be a depressed PMNL phagocytic capacity and a lower serum opsonic activity after surgery, and that the increased PMNL bactericidal capacity and high plasma elastase levels during postoperative infection may contribute to the susceptibility to multiple organ failure.
Insights
Postoperative infection risk increases with lower polymorphonuclear leukocyte (PMNL) phagocytic capacity and reduced serum opsonic activity after surgery. These immune changes predict infection susceptibility and potential organ failure.
Area of Science:
- Immunology
- Surgical Infections
- Cellular Biology
Background:
- Major surgery can significantly alter immune function.
- Polymorphonuclear leukocytes (PMNLs) and opsonins are crucial for host defense.
- Understanding perioperative immune changes is vital for managing postoperative complications.
Purpose of the Study:
- To investigate perioperative changes in polymorphonuclear leukocyte (PMNL) function and serum opsonic activity.
- To identify immune factors associated with postoperative infection after major surgery.
- To explore the relationship between immune status and the risk of multiple organ failure.
Main Methods:
- Studied 36 patients undergoing major surgery.
- Assessed PMNL phagocytic-bactericidal capacity.
- Measured serum opsonic index and plasma elastase levels.
- Quantified plasma leukotriene B4 levels.
Main Results:
- In non-infected patients, PMNL capacity and elastase increased, while opsonic index decreased immediately post-surgery, returning to baseline within 1-2 weeks.
- In infected patients, high PMNL bactericidal capacity and elastase persisted, with decreased PMNL phagocytic capacity and opsonic index after 2 weeks.
- Leukotriene B4 levels were lower in infected patients on postoperative day 1.
Conclusions:
- Depressed PMNL phagocytic capacity and reduced serum opsonic activity post-surgery are key predisposing factors for infection.
- Sustained high PMNL bactericidal capacity and elastase levels in infected patients may contribute to multiple organ failure susceptibility.