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Changes in leukocyte subpopulations following total hip replacement surgery. Effects of high doses of corticosteroids
H E Høgevold1, T Lyberg, O Reikerås
1Department of Surgery, Ullevål Hospital, University of Oslo, Norway.
Insights
High-dose corticosteroids (HDC) alter leukocyte counts after hip surgery, increasing granulocytes and decreasing lymphocytes. HDC significantly impacted immune cell populations compared to non-steroid treatment.
Area of Science:
- Immunology
- Surgical Medicine
Background:
- Leukocyte dynamics post-surgery are complex.
- The impact of high-dose corticosteroids (HDC) on these changes requires elucidation.
Purpose of the Study:
- To investigate leukocyte subpopulation changes after total hip replacement.
- To determine the effects of HDC on these postoperative immune alterations.
Main Methods:
- Randomized study comparing non-steroid and HDC groups (n=6 each).
- Analysis of leukocyte subpopulations including T-cells, B-cells, and NK cells.
- Monitoring of immune cell counts in the early postoperative period.
Main Results:
- Non-steroid group showed transient leukocytosis, monocytosis, lymphocytopenia, and granulocytosis, with significant granulocyte increase.
- HDC treatment significantly elevated leukocytes and granulocytes while reducing lymphocytes and monocytes in the first two days.
- HDC significantly decreased pan T-lymphocytes percentage post-surgery.
Conclusions:
- Post-total hip replacement surgery induces significant changes in leukocyte counts, particularly granulocytes.
- High-dose corticosteroids markedly influence these postoperative immune responses, altering leukocyte and lymphocyte levels.
Abstract:
Changes in leukocyte subpopulations and the effects of high-dose corticosteroids (HDC) on these changes were studied in patients undergoing total hip replacement surgery. Twelve patients were randomly divided into a non-steroid (n = 6) and a steroid group (n = 6). The steroid patient group was treated with HDC. In the non-steroid group, we found a leukocytosis, monocytosis, lymphocytopenia and granulocytosis after surgery in local anaesthesia. Only the changes in granulocyte counts were significant. Furthermore, the relative proportion of pan T-cells, helper/inducer T-cells, suppressor/cytotoxic T-cells, B-cells, activated T-cells and natural killer-cell subset did not change significantly during the post-operative course. Thus, lymphocytopenia was caused by reduced absolute counts of all these subsets. However, there was a tendency for decreased relative proportions of pan T-cells, inducer/helper T-cells, activated T-cells and natural killer (NK) cell subset in the early postoperative phase. Treatment with HDC significantly raised the numbers of leukocytes and granulocytes and decreased the lymphocyte and monocyte counts in the first 2 days after surgery, accounting for significant differences between the two patients groups. The percentage of pan T-lymphocytes was significantly lower in the steroid patient group on days 1 and 2 after the operation. There was no significant difference between the two patient groups with regard to the percentages of B-lymphocytes, T-lymphocyte subsets, NK cell subset, leu M3 cells and helper:suppressor ratio.(ABSTRACT TRUNCATED AT 250 WORDS)