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[Immunosuppression caused by surgery and severe trauma].

M Holch, P J Grob, W Fierz

    Helvetica Chirurgica Acta
    |June 1, 1989
    PubMed
    Summary

    Surgical procedures, from minor to major trauma, trigger physiological immunosuppression. This study monitored immune responses, finding decreased cellular and humoral immunity alongside increased macrophage activation post-surgery.

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    Area of Science:

    • Immunology
    • Surgical Physiology
    • Trauma Research

    Background:

    • Surgical interventions can induce significant physiological changes.
    • Post-operative immunosuppression is a recognized complication.
    • Understanding immune responses to trauma and surgery is crucial for patient outcomes.

    Purpose of the Study:

    • To investigate physiological immunosuppressive effects following minor and major surgical interventions.
    • To describe immunodeficiency syndromes occurring after severe trauma and surgery.
    • To monitor cellular and humoral immunity parameters in surgical patients.

    Main Methods:

    • Prospective study design.
    • Monitoring of 64 patients preoperatively and on days 1-4 post-surgery.
    • Assessment of cellular immunity (lymphocyte counts, CD4/CD8 ratio, IL2-receptors), humoral immunity (immunoglobulins, complement factors), and macrophage activation (neopterin).
    • Inclusion of diverse surgical cases: polytrauma, aortic Y-grafting, colorectal resection, cholecystectomy, and inguinal herniotomy.

    Main Results:

    • A decrease in cellular immunity parameters, including absolute lymphocyte count, CD-4/CD-8 cell ratio, and IL2-receptor release.
    • A reduction in humoral defense markers such as immunoglobulins and complement factors.
    • An observed increase in macrophage activation, indicated by elevated serum neopterin levels.

    Conclusions:

    • Both minor and major surgical interventions lead to measurable immunosuppression.
    • Severe trauma and complex surgeries significantly impair cellular and humoral immune functions.
    • Increased macrophage activation suggests an inflammatory response accompanying immunosuppression post-surgery.

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