Effect of non-operative management (NOM) of splenic rupture versus splenectomy on the distribution of peripheral blood lymphocyte populations and cytokine production by T cells
Effect of non-operative management (NOM) of splenic rupture versus splenectomy on the distribution of peripheral blood lymphocyte populations and cytokine production by T cells
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DOI：
10.1111/j.1365-2249.2007.03517.x
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发表时间：
2007-12-01
影响因子：
4.6
通讯作者：
Karakantza, M.
中科院分区：
文献类型：
--
作者：
Theodorou, G. L.;Mouzaki, A.;Karakantza, M.
创伤后脾切除术与术后发病率和死亡率的增加以及体液和细胞免疫的长期损害有关。已经开发了手术的替代方案，以最大限度地减少或避免脾切除术的即时和/或长期并发症。在此，我们研究了创伤性脾破裂的非手术治疗（NOM）对外周血（PB）淋巴细胞群分布和T细胞产生细胞因子的长期影响。PB样本来自6名NOM患者，13名年龄匹配的创伤后接受脾切除术的成年人（SP患者）和31名年龄匹配的对照。通过流式细胞术在全血+/-有丝分裂原中测定T细胞中的细胞表型和干扰素（IFN）-γ、白细胞介素（IL）-2、IL-4和IL-10细胞因子的细胞内产生。与对照组相比，NOM患者淋巴细胞的绝对数量或其亚群的分布没有任何变化。相比之下，SP患者显示淋巴细胞、CD 8 T细胞、活化的CD 8 T细胞、自然杀伤（NK）T细胞、NK细胞和γ δ T细胞的百分比和/或绝对数量持续增加，并且初始CD 4 T细胞减少。NOM组T细胞的组成性或诱导性细胞因子产生与对照组相似，而SP患者的组成性IL-2和IFN-γ产生的CD 8 T细胞和IFN-γ产生的CD 4 T细胞的百分比增加。我们的研究结果共同表明，在NOM的愈合过程中不会影响脾脏的结构到这样的程度，它会导致长期的PB淋巴细胞或T细胞的细胞因子谱的比例的改变。
Post-traumatic splenectomy is associated with increased postoperative morbidity and mortality and long-term impairment of humoral and cellular immunity. Alternatives to surgery have been developed to minimize or avoid the immediate and/or long-term complications of splenectomy. Herein we investigated the long-term effect of non-operative management (NOM) of the traumatic rupture of the spleen on the distribution of peripheral blood (PB) lymphocyte populations and cytokine production by T cells. PB samples were drawn from six NOM patients, 13 age-matched adults who had undergone splenectomy after trauma (SP patients) and 31 age-matched controls. Cellular phenotypes and the intracellular production of interferon (IFN)-gamma, interleukin (IL)-2, IL-4 and IL-10 cytokines in T cells were determined in whole blood +/- mitogens by flow cytometry. NOM patients did not show any changes in the absolute numbers of lymphocytes or the distribution of their subsets, compared to the controls. In contrast, SP patients showed a sustained increase in the percentage and/or absolute numbers of lymphocytes, CD8 T cells, activated CD8 T cells, natural killer (NK) T cells, NK cells and gamma delta T cells, and a reduction in naive CD4 T cells. The constitutive or induced cytokine production by T cells of the NOM group was similar to the control group, whereas SP patients had increased percentages of constitutive IL-2- and IFN-gamma-producing CD8 T cells and IFN-gamma-producing CD4 T cells. Our findings indicate collectively that the healing process in NOM does not affect the architecture of the spleen to such an extent that it would lead to long-term alterations of the proportions of PB lymphocytes or the T cell cytokine profiles.