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The influence of surgical stress on the psychoneuro-endocrine-immune axis
S A Dahanukar1, U M Thatte, U D Deshmukh
1Department of Pharmacology, GS Medical College & KEM Hospital, Parel, Mumbai.
Abstract:
Stress is known to depress the immune system severely. This study was done to evaluate whether surgical stress influenced polymorphonuclear (PMN) and monocyte functions in association with serum cortisol and the anxiety score as measured on the HARS Rating Scale. We found that surgery (irrespective of whether it was major or minor) significantly depressed PMN and monocyte functions and increased serum cortisol levels. PMN phagocytosis correlated significantly (p < 0.05) with the rise in serum cortisol. In spite of these changes, postoperative clinical recovery was uneventful. No major alterations in the HARS scores were noted pre and post operatively. This study demonstrates that surgical stress depresses the immune system with a concomitant rise in cortisol.
Insights
Surgical stress significantly impairs immune cell function, including polymorphonuclear (PMN) and monocyte activity, while elevating cortisol levels. Despite these immune changes, patients experienced normal postoperative recovery.
Area of Science:
- Immunology
- Endocrinology
- Surgical Stress Response
Background:
- Stress is a known immunosuppressant.
- The impact of surgical stress on immune cells and stress hormones requires further elucidation.
Purpose of the Study:
- To investigate the effects of surgical stress on polymorphonuclear (PMN) and monocyte functions.
- To correlate these immune changes with serum cortisol levels and anxiety scores (HARS).
Main Methods:
- Assessing PMN and monocyte functions pre- and post-surgery.
- Measuring serum cortisol levels.
- Utilizing the Hamilton Anxiety Rating Scale (HARS) for anxiety assessment.
Main Results:
- Surgery significantly depressed both PMN and monocyte functions.
- Serum cortisol levels increased significantly after surgery.
- PMN phagocytosis showed a significant negative correlation with increased serum cortisol (p < 0.05).
- No significant changes in HARS scores were observed pre- and post-operatively.
Conclusions:
- Surgical stress demonstrably depresses immune system function.
- This immune suppression is associated with a concurrent increase in serum cortisol levels.
- Despite immune modulation, uncomplicated postoperative recovery suggests resilience or other compensatory mechanisms.