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[The effect of craniotomy on lymphocyte subpopulations]
Y Hori1, T Hosokawa, T Hashimoto
1Department of Anesthesiology, Kyoto Prefectural University of Medicine.
Insights
Craniotomy significantly impacts cell-mediated immunity, decreasing T-cell populations and altering helper/suppressor ratios. This immune modulation suggests surgical stress affects immunological balance.
Area of Science:
- Immunology
- Neuroscience
- Surgical Oncology
Context:
- Craniotomy is a major neurosurgical procedure.
- Cell-mediated immunity plays a crucial role in immune response.
- Understanding immune changes post-craniotomy is vital for patient care.
Purpose:
- To investigate the effects of craniotomy on cell-mediated immunity.
- To analyze changes in T-cell subsets (helper, suppressor, cytotoxic) during and after surgery.
- To correlate immunological shifts with surgical stress.
Summary:
- Flow cytometry and monoclonal antibodies were used to examine T-cell populations in 12 patients undergoing craniotomy.
- A decrease in total T-cells (Leu4) and helper T-cells (Leu3a) was observed post-incision.
- The helper/suppressor T-cell ratio (Leu3a/Leu2a) declined, with specific changes in inducer, helper, and suppressor T-cell subsets.
Impact:
- Craniotomy-induced stress demonstrably affects the immunological state.
- Findings highlight the need for monitoring immune function in neurosurgical patients.
- This research provides insights into the neuro-immune interactions during major cranial surgery.
Abstract:
The effect of craniotomy on cell mediated immunity was studied by using monoclonal antibodies and flow cytometry. Twelve patients undergoing craniotomy were investigated. Six patients had malignant brain tumor, four benign tumor, one AVM and one aneurysm. Examined lymphocyte monoclonal antibodies were Leu4, Leu2a and Leu3a. In addition, two color analysis using two monoclonal antibodies, Leu3a and Leu8, or Leu2a and Leu15, was performed. This technique can classify Leu3a positive cell into helper T cell and inducer T cell and Leu2a positive cell into suppressor T cell and cytotoxic T cell. The number of Leu4 positive cell (T cell) decreased during operation. The number of Leu3a positive cell (OKT4) also decreased at 30 minutes after incision and moderately recovered during operation. Leu2a positive cell (OKT8) did not show significant change. As the result, the decline of Leu3a/Leu2a ratio (OKT4/OKT8 ratio) was found after incision and this ratio gradually returned to preoperative level during operation. By two color analysis, decrease of inducer and helper T cell in Leu3a positive cell, and increase of suppressor T cell, and decrease of cytotoxic T cell in Leu2a positive cell were observed. The results of this study show that stress of craniotomy affected the immunological state.