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Surgical stress induces endotoxin hyporesponsiveness and an early decrease of monocyte mCD14 and HLA-DR expression during surgery [Article de Revue]

 
[L'ulcère de stress induit une diminution de la capacité de réponse de l'endotoxine et une diminution précoce de l'expression de MCD14 et HLA-DR par le monocyte au cours de la chirurgie]
KAWASAKI T ; OGATA M ; KAWASAKI C ; TOMIHISA T ; OKAMOTO K ; SHIGEMATSU A
Anesthesia and analgesia. 2001; 92(5) : 1322-1326
Summary: La chirurgie majeure est associée à des altérations sévères des mécanismes de défense de l'hôte. Cette étude a inclus 20 patients volontaires bénéficiant d'une gastrectomie partielle et les modifications du système immunitaire ont été étudiées. Les résultats montrent qu'être attentif à l'immunosuppression dans la période précoce de la chirurgie est important pour la prévention des infections postopératoires.

It is generally accepted that major surgery is associated with severe alterations of the host-defense mechanisms. We investigated the effect of surgical stress on the immune system. Specifically, we studied the relationship between perioperative lipopolysaccharide (LPS) hyporesponsiveness and monocyte human leukocyte antigen-DR (HLA-DR) and CD14 expression during the perioperative period in 20 patients who underwent partial gastrectomy. This study demonstrated that surgical stress rapidly depressed monocyte mCD14 and HLA-DR expression in comparison with preanesthesia levels. Monocyte mCD14 expression recovered to preoperative levels on the first postoperative day, and monocyte HLA-DR expression recovered by the seventh postoperative day. Consistent with our previous study, LPS-induced tumor necrosis factor (TNF)-alpha production ex vivo was significantly suppressed from the beginning of the operation. On the contrary, the plasma interleukin-10 concentration started to increase after the surgical incision was made. LPS hyporesponsiveness was least at the end of the operation and returned to preoperative levels on the first postoperative day. In conclusion, the present study demonstrated that LPS responsiveness, plasma interleukin-10 concentration, and monocytes mCD14 and HLA-DR expression altered from the early period of surgery. These alterations may be related to the impairment of the immune system during the perioperative period. IMPLICATIONS: Recent studies demonstrate that surgical stress induces immune dysfunction. We found that surgical stress rapidly decreased monocyte mCD14 and human leukocyte antigen-DR expression, and endotoxin responsiveness. These findings suggest that early changes of the immune system caused by surgical stress contribute to postoperative complications such as sepsis and multiple organ failure.(RESUME D'AUTEUR)
Publication
2001

Pages
1322-1326

Language
Anglais

Number of ref
31

ID notice
319257

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CCLIN Est
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Hospices Civils de Lyon
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http://cclin-sudest.chu-lyon.fr/
CCLIN Sud-Ouest
CClin Sud-Ouest
CHU de Bordeaux
Hôpital Pellegrin - Bâtiment Le Tondu
33076 Bordeaux
Tél : 05.56.79.60.58
cclin.so@chu-bordeaux.fr
http://www.cclin-sudouest.com/

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