Preoperative Toll-like receptor expression in monocytes is associated with host immunological responses following...

The present study was designed to evaluate the relationship between preoperative Toll-like receptor (TLR) expression in peripheral blood monocytes (PBMC) and the postoperative inflammatory cytokine secretion from PBMC, as well as the postoperative infectious complications in patients with gastrointestinal cancer.

Peripheral blood monocytes were isolated from 26 patients on the preoperative day and on postoperative day 1 (POD1). The monocytes were stained for CD14, TLR2, and TLR4 surface expression and stimulated ex vivo with lipopolysaccharide (LPS), after which the culture supernatant tumor necrosis factor alpha (TNFα), interleukin (IL)-1β, and interferon gamma (IFNγ) concentrations were measured in the culture supernatant. Postoperative clinical courses were monitored.

There was a significant positive correlation between preoperative TLR4 expression and clinical stage in patients with gastrointestinal cancer. A significant negative correlation between preoperative TLR2 or TLR4 expression and the preoperative TNFα and IL-1β production was found. Furthermore, there was a significant negative correlation between preoperative TLR2 or TLR4 expression and postoperative inflammatory cytokine production.

Preoperative high expression of TLR on monocytes reduces the capacity for LPS-induced inflammatory cytokine production from monocytes. An analysis of preoperative TLR expression may therefore help to elucidate the systemic immunological response and the clinical course following gastrointestinal surgery.