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Mac-1 expression and superoxide generation of the peripheral polymorphonuclear leukocyte following gastrectomy and
Y Imamura1, T Yokoyama, Y Murakami
1First Department of Surgery, Hiroshima University School of Medicine, Japan.
Abstract:
The aim of this study was to evaluate the characteristics of the polymorphonuclear leukocyte (PMN) function after surgical stress. We investigated Mac-1 expression and superoxide generation by peripheral PMNs and serum granulocyte-colony stimulating factor (G-CSF) concentrations in 15 patients who underwent either gastrectomy (n = 8) or esophagectomy (n = 7). The serum G-CSF rapidly increased within 24 hours after operation. The maximum levels of serum G-CSF in the cases of esophagectomy were about 5-8 fold those of gastrectomy, although the increases in PMN counts within 24 hours of esophagectomy were lower than those after gastrectomy. Mac-1 expression and superoxide generation by PMN counts and serum G-CSF. After esophagectomy, Mac-1 expression on peripheral PMNs remained elevated through the 7th day after operation, while superoxide generation by PMNs in response to PMA declined to below preoperative levels after the 3rd day. These results suggest that, after major surgery such as esophagectomy, there is a discrepancy between Mac-1 expression and superoxide generation by the peripheral PMN despite a high level of serum G-CSF.
Insights
Surgical stress impacts polymorphonuclear leukocyte (PMN) function. Despite elevated granulocyte-colony stimulating factor (G-CSF) after esophagectomy, PMN superoxide generation decreased, indicating a functional discrepancy.
Area of Science:
- Immunology
- Surgical Science
Background:
- Surgical stress significantly impacts immune cell function.
- Polymorphonuclear leukocytes (PMNs) play a crucial role in the immune response to surgical trauma.
- Granulocyte-colony stimulating factor (G-CSF) is a key regulator of neutrophil production and function.
Purpose of the Study:
- To investigate polymorphonuclear leukocyte (PMN) function following surgical stress.
- To evaluate Mac-1 expression and superoxide generation by peripheral PMNs.
- To measure serum granulocyte-colony stimulating factor (G-CSF) concentrations post-surgery.
Main Methods:
- Studied 15 patients undergoing gastrectomy or esophagectomy.
- Measured peripheral PMN Mac-1 expression and superoxide generation.
- Assessed serum G-CSF concentrations at various time points post-operation.
Main Results:
- Serum G-CSF levels increased rapidly within 24 hours post-surgery, with higher levels after esophagectomy than gastrectomy.
- Despite elevated G-CSF and sustained Mac-1 expression after esophagectomy, PMN superoxide generation declined below preoperative levels by day 3.
- PMN counts increased less after esophagectomy compared to gastrectomy.
Conclusions:
- Major surgery like esophagectomy induces a dissociation between Mac-1 expression and superoxide generation in peripheral PMNs.
- Elevated serum G-CSF does not fully restore PMN functional capacity after extensive surgical stress.
- Further research is needed to understand the implications of this PMN functional impairment post-surgery.
