Miniello S, Jirillo E, Urgesi G, D'Abbicco D, Altamura M, Tomasicchio N, Bonomo G M
Istituto di Chirurgia Generale II, Università degli Studi di Bari.
Chir Ital. 1999 May-Jun;51(3):215-9.
This paper attempts to explain if immunodepression in patients who had undergone a splenectomy may be due to altered balance between Th1-Th2 lymphocyte subpopulations, as shown in several studies on phagocyte and lymphocyte cells. This was achieved by dosing serum levels of IFNg, produced by Th1 lymphocytes and IL-4, produced by Th2 lymphocytes. Final analysis showed immunodepression in splenectomized patients but also emphasized that in 70% of all cases, there is functional damage of T-lymphocytes that continues for several years after the surgery involving both cellular and humoral immunity. Immunoglobulin dosage allows the increase of IgE to be seen in 50% of the splenectomized patients studied, all with allergic symptoms that appeared after the operation. The production of IgE is stimulated by Th2 lymphocytes. This leaves one to believe that splenectomy may favour the persistence of allergens in the blood, the appearance of allergic symptoms and the increase of IgE serum levels in patients with normal Th2 functioning and consequently, with normal or increased IL-4 serum levels.
本文试图解释，正如在一些关于吞噬细胞和淋巴细胞的研究中所显示的那样，接受脾切除手术的患者出现免疫抑制是否可能归因于Th1-Th2淋巴细胞亚群之间平衡的改变。这是通过检测Th1淋巴细胞产生的IFNg和Th2淋巴细胞产生的IL-4的血清水平来实现的。最终分析显示脾切除患者存在免疫抑制，但也强调在所有病例的70%中，存在T淋巴细胞功能损伤，这种损伤在手术后持续数年，涉及细胞免疫和体液免疫。免疫球蛋白检测发现，在50%接受研究的脾切除患者中IgE有所增加，所有这些患者都在术后出现了过敏症状。IgE的产生由Th2淋巴细胞刺激。这让人认为，脾切除可能有利于过敏原在血液中持续存在，导致过敏症状出现，并且在Th2功能正常、因此IL-4血清水平正常或升高的患者中，会使IgE血清水平升高。
