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Polymorphonuclear leukocyte function and serum opsonic activity in surgical patients.
1Second Department of Surgery, Tokyo Medical and Dental University, Japan.
Surgery Today
|January 1, 1992
Summary
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.