[Surgical trauma and postoperative immunosuppression].

P Koerner, A Westerholt, W Kessler, T Traeger, S Maier, C-D Heidecke
Author Information
  1. P Koerner: Klinik und Poliklinik für Chirurgie, Abteilung für Allgemein-, Viszeral-, Thorax- und Gefässchirurgie, Universitätsklinikum Greifswald, Greifswald, Germany.

Abstract

Abdominal surgery is regularly followed by immune dysfunction that can last for several days. In case of septic complications during this period, there is imminent danger of mortality due to reduced immune function. This fact leads to classification of sepsis in regard to its genesis: spontaneously acquired sepsis type A is distinguishable from sepsis type B, which is acquired postoperatively. The main difference between these types is the immunologic condition at the time point of sepsis development. Postoperative immune dysfunction can be described by several parameters, i.e. reduction of HLA-DR expression on monocytes and increased apoptosis of T lymphocytes. A direct correlation exists between magnitude of immune dysfunction and complexity of the previous surgical trauma. For the first time it is now possible to study this phenomenon of postoperative immune dysfunction by use of an adequate animal model. Intestinal manipulation in mice fulfils the necessary criteria to serve as a model of surgically induced immune dysfunction.

References

Am J Surg. 1999 Jan;177(1):55-60 [PMID: 10037309]
Infect Immun. 2001 Jun;69(6):3550-5 [PMID: 11349012]
Ann Surg. 2006 Aug;244(2):220-9 [PMID: 16858184]
Infect Immun. 1998 May;66(5):2300-9 [PMID: 9573121]
Int J Colorectal Dis. 2006 Jan;21(1):64-70 [PMID: 15756596]
Arch Surg. 2004 Nov;139(11):1221-4 [PMID: 15545570]
Ann Surg. 1998 Nov;228(5):652-63 [PMID: 9833803]
Dis Colon Rectum. 2005 May;48(5):1021-6 [PMID: 15789125]
Surg Endosc. 2001 Jun;15(6):600-8 [PMID: 11591950]
Shock. 2004 Jun;21(6):505-11 [PMID: 15167678]
Surg Endosc. 1998 Aug;12(8):1020-4 [PMID: 9685534]
Transplant Proc. 2006 Jul-Aug;38(6):1815-7 [PMID: 16908290]
Infect Immun. 1997 Jun;65(6):2283-91 [PMID: 9169765]
J Surg Res. 1997 Feb 15;68(1):24-30 [PMID: 9126191]
Gut. 2007 Feb;56(2):176-85 [PMID: 16809419]
Chirurg. 2000 Feb;71(2):159-65 [PMID: 10734584]
Langenbecks Arch Surg. 2005 Aug;390(4):333-41 [PMID: 15995884]
Chirurg. 2005 Sep;76(9):829-36 [PMID: 16028047]

MeSH Term

Animals
Apoptosis
Disease Models, Animal
HLA-DR Antigens
Humans
Immune Tolerance
Immunologic Deficiency Syndromes
Intestinal Diseases
Monocytes
Postoperative Complications
Sepsis
Surgical Wound Infection
T-Lymphocytes

Chemicals

HLA-DR Antigens

Word Cloud

Similar Articles

Cited By