Surgical stress induces a shift in the type-1/type-2 T-helper cell balance, suggesting down-regulation of cell-mediated and up-regulation of antibody-mediated immunity commensurate to the trauma

摘要: Background. Measuring serum cytokines, pituitary hormones, or acute phase proteins during after surgery is not an optimal method for quantifying the impact of surgical procedures. In effort to assess stress by means immune response, we focused on changes in cell-mediated and antibody-mediated immunity as illustrated type 1/type 2 T-helper (Th1/Th2) cell balance. The sensitivity this approach was evaluated comparing laparoscopic conventional cholecystectomy (LCE, CCE). Methods. a pragmatic prospective study 43 patients with symptomatic cholelithiasis were operated either LCE (n=25) CCE (n=18). Blood sampling done 24 hours before surgery, immediately incision, 2, 24, 48 surgery. Cell surface markers cytokine production used characterize Th1/Th2 balance measured flow cytometry enzyme-linked immunosorbent assay techniques. Results. Activation Th2 cells evokes secretion interleukin-4 (IL-4), which up-regulates expression immunoglobulin E receptors (FœRII, CD23) B cells. Phytohemagglutinin-induced IL-4 freshly isolated peripheral blood mononuclear from increased more than (IL-4, +41% versus +17%; p Conclusions. This shows that induces shift toward Th2, suggesting down-regulated up-regulated evaluation may be clinically meaningful help quantify even less invasive When strictly randomized study, found stressful procedure.