Neutrophil function, serum opsonic activity, and delayed hypersensitivity in surgical patients

Area of Science:

• Immunology
• Surgical Pathology

Background:

• Surgical procedures can significantly impact the host's immune system.
• Assessing immune function post-surgery is crucial for understanding patient recovery and potential complications.

Purpose of the Study:

• To evaluate the effects of major surgery on key components of the immune system.
• Specifically investigating polymorphonuclear leukocyte (PMN) function, delayed hypersensitivity, and serum opsonic capacity.

Main Methods:

• Studied 29 patients undergoing major abdominal surgery.
• Assessed PMN phagocytosis, chemiluminescence, and chemotaxis.
• Measured delayed hypersensitivity via skin testing with recall antigens.
• Evaluated serum opsonic capacity using Staphylococcus opsonization by patient sera and normal PMNs.

Main Results:

• Phagocytic capacity and chemiluminescence of PMNs remained normal post-surgery.
• Chemotactic activity of PMNs was diminished in 48% of patients, though not definitively linked to surgery.
• Delayed hypersensitivity was depressed in approximately 30% of patients post-operation (mean induration decreased from 6.9mm to 3.6mm, P=0.006).
• Serum opsonic capacity significantly decreased after surgery compared to pre-operative levels in the same patients.
• Decreased opsonic capacity correlated with lower IgG levels in some patients, but not complement activity.

Conclusions:

• Major surgery can lead to a decline in specific immune functions, including PMN chemotaxis and delayed hypersensitivity.
• Postoperative serum exhibits reduced ability to opsonize bacteria, potentially compromising immune defense.
• These immune alterations may have implications for patient outcomes following major surgical interventions.