[Perioperative alterations in polymorphonuclear leukocyte function mediated by protein kinase C]

To characterize the perioperative alterations in polymorphonuclear leukocytes (PMN) function mediated by protein kinase C, we studied twenty six patients undergoing gastrointestinal surgery. Seventeen patients with thoracic esophageal cancer were underwent total thoracic esophagectomy through a right thoracotomy (severe surgical stress group). Nine patients underwent cholecystectomy (slight surgical stress group). Measurement of O2- production capacity was used as a reflection of the activity of NADPH oxidase, and the activity of myeloperoxidase-H2O2-halide system was evaluated using luminol-dependent chemiluminescence. O2- production stimulated by phorbol 12-myristate 13-acetate (PMA) was suppressed, reaching a minimum on POD 3. On the other hand, luminol dependent chemiluminescence increased significantly after surgery, reached a maximum on POD 3. These alterations were more remarkable in the severely stressed patients. These results suggest that postoperative PMN signal transduction mechanisms, mediated by protein kinase C, may activate myeloperoxidase-H2-O2-halide system but suppress NADPH oxidase system dependently of the degree of surgical stress, revealing a differential effect of protein kinase C activation on PMN microbicidal activity.