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Monocyte activation after open and laparoscopic surgery

A Klava1, A Windsor, A W Boylston

  • 1Professorial Surgical Unit, St James's University Hospital, Leeds, UK.

The British Journal of Surgery
|August 1, 1997
PubMed
Summary
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Surgical operations, both open and laparoscopic, significantly reduce monocyte HLA-DR expression. Post-surgery, monocytes become less responsive to interferon-gamma (IFN-gamma), suggesting limited effectiveness of IFN-gamma as a sepsis treatment after major surgery.

Area of Science:

  • Immunology
  • Surgical Research
  • Critical Care Medicine

Background:

  • Monocyte human leucocyte antigen (HLA)-DR expression correlates with sepsis development post-surgery or trauma.
  • Interferon-gamma (IFN-gamma) normally enhances monocyte HLA-DR expression, indicating potential prophylactic use against sepsis.
  • Surgical trauma impacts immune cell function, specifically monocyte response to immune modulators.

Purpose of the Study:

  • To investigate the impact of conventional open and laparoscopic surgery on monocyte's capacity to respond to IFN-gamma.
  • To compare the immune response modulation between open and laparoscopic surgical procedures.

Main Methods:

  • Whole blood flow cytometry was employed to quantify monocyte HLA-DR antigen expression.
  • Monocyte activation was assessed using IFN-gamma and bacterial lipopolysaccharide (LPS) stimulation.

Related Experiment Videos

  • Blood samples were collected from 43 open surgery patients and 15 laparoscopic surgery patients pre- and post-operation.

    • Main Results:

    • Both surgical approaches led to a significant decrease in whole blood monocyte HLA-DR expression post-operation.
    • IFN-gamma stimulation showed reduced efficacy in increasing monocyte HLA-DR expression after surgery compared to pre-operation.
    • Lipopolysaccharide (LPS) stimulation yielded similar, albeit more pronounced, reductions in monocyte activation post-surgery.

    Conclusions:

    • Surgical procedures diminish monocyte HLA-DR expression and induce relative refractoriness to IFN-gamma and LPS stimulation.
    • Laparoscopic surgery demonstrates an equivalent suppressive effect on monocyte immune function as conventional open surgery.
    • The reduced responsiveness of postoperative monocytes to IFN-gamma suggests its limited utility as a biological response modifier in the post-surgical setting.