Downregulation of T helper type 1 immune response and altered pro-inflammatory and anti-inflammatory T cell cytokine balance following conventional but not laparoscopic surgery.

摘要: Abstract Background: The clinical advantages of laparoscopic procedures result from a minimized surgical trauma. present study was performed to investigate immunosupression following operations as compared with open surgery. Our analysis focused on the T cell secretion cytokines that regulate critical balance either helper type-1 (Th1)- and Th2-mediated immune responses pro- anti-inflammatory activities. Methods: In prospective study, immunological data 26 patients submitted cholecystectomy (LCE) 17 undergoing conventional (CCE) for symptomatic cholecystolithiasis were compared. Patients acute cholecystitis developing postoperative complications or receiving immunosuppressive medication excluded. Production interferon (IFN)-γ, interleukin (IL)-2, IL-4, tumor necrosis factor (TNF)-α, IL-10 by isolated cells stimulated cross-linking CD3 CD28 evaluated preoperatively well days 1 6 7. Cytokines measured immunoenzymometric assay. Results: IFN-γ, TNF-α, IL-2 production decreased significantly 48.3%, 36.6%, 36.8%, respectively, day after CCE, but not LCE. These results indicate severe suppression Th1-type pro-inflammatory operation. contrast, IL-4 did show significant changes in group suggesting Th2 response activity remained normal. Conclusions: shows open, is associated marked lymphocytes functions indicated deregulation both Th1/Th2 pro-/anti-inflammatory cytokine balance. therefore suggest downregulation Th1 cell–mediated hallmark