Innate immunity recovers earlier than acquired immunity during severe postoperative immunosuppression.
Innate immunity recovers earlier than acquired immunity during severe postoperative immunosuppression.
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DOI：
10.7150/ijms.21433
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发表时间：
2018
影响因子：
3.6
通讯作者：
Spies C
中科院分区：
文献类型：
--
作者：
Lachmann G;von Haefen C;Kurth J;Yuerek F;Spies C
背景资料：术后免疫抑制，特别是细胞介导的免疫力丧失，在手术后很常见，并且与更差的结果相关，即伤口愈合延迟、感染、败血症、多器官衰竭和癌症复发。然而，在严重的术后免疫抑制期间，没有研究免疫细胞的恢复，重点是先天性和获得性免疫之间的差异。研究方法：在这项回顾性随机对照试验（RCT）亚组分析中，分析了10例食管或胰腺切除术后免疫抑制患者。术前（od）至术后第5天（pod 5）检测先天性和获得性免疫细胞、单核细胞相关人类白细胞抗原-D表达（mHLA-DR）、脂多糖（LPS）诱导的单核细胞TNF-α和IL-10体外分泌、刀豆球蛋白A（Con A）诱导的IFN-γ、TNF-α、IL-2、IL-4、IL-5和IL-10释放。免疫细胞的恢复定义为术后显著变化后分别显著降低和升高。使用非参数统计程序进行统计分析。结果如下：先天性免疫细胞的术后改变在pod 2（嗜酸性粒细胞）、pod 3（中性粒细胞）和pod 5（mHLA-DR、单核细胞TNF-α和IL-10分泌）恢复，而获得性免疫细胞（淋巴细胞、T细胞、T辅助细胞和细胞毒性T细胞）的改变直到pod 5才恢复。外周血T细胞显示在pod 1上Con A刺激后辅助性T细胞（Th）1细胞因子IFN-γ的产生受损，而Th 2特异性细胞因子释放直到pod 5才发生变化。结论：在严重的术后免疫抑制中，天然免疫比获得性免疫更早恢复。此外，我们发现手术后第一天的抗炎T细胞功能比促炎T细胞功能更强，而T细胞计数下降。
Background: Postoperative immune suppression, particularly a loss of cell-mediated immunity, is commonly seen after surgery and is associated with worse outcome, i.e. delayed wound healing, infections, sepsis, multiple-organ failure and cancer recurrence. However, the recovery of immune cells focusing on differences between innate and acquired immunity during severe postoperative immunosuppression is not investigated. Methods: In this retrospective randomized controlled trial (RCT) subgroup analysis, 10 postoperatively immune suppressed patients after esophageal or pancreatic resection were analyzed. Innate and acquired immune cells, the expression of human leukocyte antigen-D related on monocytes (mHLA-DR), lipopolysaccharide (LPS)-induced monocytic TNF-α and IL-10 secretion ex vivo, Concanavalin A (Con A)-induced IFN-γ, TNF-α, IL-2, IL-4, IL-5 and IL-10 release were measured preoperatively (od) until day 5 after surgery (pod5). Recovery of immune cells was defined by a significant decrease respectively increase after a significant postoperative alteration. Statistical analyses were performed using nonparametric statistical procedures. Results: Postoperative alterations of innate immune cells recovered on pod2 (eosinophils), pod3 (neutrophils) and pod5 (mHLA-DR, monocytic TNF-α and IL-10 secretion), whereas alterations of acquired immune cells (lymphocytes, T cells, T helper cells, and cytotoxic T cells) did not recover until pod5. Peripheral blood T cells showed an impaired production of the T helper (Th) 1 cytokine IFN-γ upon Con A stimulation on pod1, while Th2 specific cytokine release did not change until pod5. Conclusions: Innate immunity recovered earlier than acquired immunity during severe postoperative immunosuppression. Furthermore, we found a more anti- than pro-inflammatory T cell function on the first day after surgery, while T cell counts decreased.
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影响因子：
3
作者：
Brune, IB;Wilke, W;Siewert, JR
通讯作者：
Siewert, JR
影响因子：
15.1
作者：
Bartal, Inbal;Melamed, Rivka;Ben-Eliyahu, Shamgar
通讯作者：
Ben-Eliyahu, Shamgar
影响因子：
--
作者：
Delogu, G;Moretti, S;De Simone, C
通讯作者：
De Simone, C
影响因子：
9
作者：
Goldfarb, Yael;Sorski, Liat;Ben-Eliyahu, Shamgar
通讯作者：
Ben-Eliyahu, Shamgar
影响因子：
3.6
作者：
Lachmann, Gunnar;Kurth, Johannes;Spies, Claudia
通讯作者：
Spies, Claudia