Search for immunomodulatory effects of blood transfusion in gastric cancer patients: flow cytometry of Th1/Th2 cells in peripheral blood.
Search for immunomodulatory effects of blood transfusion in gastric cancer patients: flow cytometry of Th1/Th2 cells in peripheral blood.
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发表时间：
2001-04
影响因子：
0.8
通讯作者：
Chien-Feng C. Sun;Yi-Yueh Hsieh;K. Ngan;Wei-Ting Wang
中科院分区：
文献类型：
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作者：
Chien-Feng C. Sun;Yi-Yueh Hsieh;K. Ngan;Wei-Ting Wang
同种异体输血似乎会驱动免疫系统转向 Th2 反应，远离 Th1 反应，为输血诱导的免疫调节提供了一种假设机制。通过流式细胞术的胞浆内细胞因子检测技术，可以测定来自外周血单核细胞的Th1和Th2细胞。本研究评估了 11 名接受围手术期输血的胃切除术后的胃癌患者与 11 名接受胃切除术但未输血的胃癌患者相比，输血诱导的免疫调节的存在情况。在这些患者中测量了淋巴细胞亚群，包括CD4 T细胞、CD8 T细胞、CD4/CD8比率、CD2(+) T细胞、CD3(+) T细胞和CD19(+) B细胞，以及可能表明输血诱导的免疫调节的变量，例如抗生素使用时间、住院时间和住院总费用。这项研究还测量了 Th1/Th2 比率的变化。通过流式细胞术测量细胞内细胞因子的表达来表征 Th1 和 Th2 淋巴细胞。在布雷菲德菌素-A 存在的情况下，用佛波醇肉豆蔻酸酯乙酸酯和离子霉素刺激细胞。结果显示，胃切除术后输血和非输血胃癌患者的淋巴细胞亚群、Th1/Th2比值、总住院费用或抗生素使用时间没有显着差异。唯一显着的差异是，与非输血患者（平均 16.2 天）相比，输血患者的住院时间（平均 20.5 天）更长。输血后未观察到预期的 Th2 反应。可能需要更多的患者群体来记录这种效果，因为许多混杂变量会影响这些患者的发病率和手术结果。
Allogeneic transfusion seems to drive the immune system toward a Th2 response and away from a Th1 response, providing a hypothetical mechanism for transfusion-induced immunomodulation. By means of an intracytoplasmic cytokine detection technique with flow cytometry, it is possible to measure Th1 and Th2 cells derived from peripheral blood mononuclear cells. This study evaluated the presence of transfusion-induced immunomodulation in 11 gastric cancer patients after gastrectomy with perioperative blood transfusion, compared to 11 gastric cancer patients who were treated by gastrectomy without transfusion. Lymphocytes subsets, including CD4 T cells, CD8 T cells, CD4/CD8 Ratio, CD2(+) T cells, CD3(+) T cells, and CD19(+) B cells, were measured in these patients, as well as variables that might suggest transfusion-induced immunomodulation, such as duration of antibiotic use, duration of hospital stay, and total hospital charges. This study also measured changes in the Th1/Th2 ratio. Th1 and Th2 lymphocytes were characterized by measuring intracellular expression of cytokines with flow cytometry. Cells were stimulated with phorbol myristate acetate and ionomycin in the presence of brefeldin-A. The results showed no significant differences in lymphocyte subsets, Th1/Th2 ratio, total hospital charges, or duration of antibiotic utilization between the groups of transfused and non-transfused gastric cancer patients after gastrectomy. The only significant difference was a longer hospital stay for transfused patients (mean 20.5 da) compared to non-transfused patients (mean 16.2 da). The anticipated finding of a Th2 response after blood transfusion was not observed. A larger group of patients may be needed to document such an effect, since many confounding variables affect the morbidity and outcome of surgery in these patients.