Murakami Saburo, Sakata Hideto, Tsuji Yoshitaka, Okubo Katsuhiko, Takahashi Takehiro, Kikuchi Masataka, Hirayama Renzo
Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama-machi, Iruma-gun, 350-0945, Saitama, Japan.
Surg Today. 2003;33(8):565-70. doi: 10.1007/s00595-003-2568-5.
Surgical stress induces alterations in numerous physiological functions, including the cell-mediated immune response. It is known that interleukin-2 receptor (IL-2R) is released from its specific affinity membrane receptor on activated T lymphocytes and then is detected as a form of the alpha-chain of the IL-2R in the bloodstream. The levels of serum-soluble IL-2R (sIL-2R) reflect the quantity of activated T lymphocytes. This study investigated the changes in the serum sIL-2R levels and the relationship of such changes with other cytokines and the number of lymphocytes after abdominal surgery.
Twenty-four patients who were scheduled to undergo abdominal operations were enrolled in this study. Blood samples of these cases were collected before surgery, and on postoperative days (POD) 1, 3, 7, and 14. The levels of serum sIL-2R were measured by an enzyme-linked immunosorbent assay.
The levels of serum sIL-2R achieved the maximal values on POD 1, and gradually decreased until POD 14. The levels of serum sIL-2R on POD 1, 3, and 7 were significantly higher than the preoperative levels. There was a significant and positive correlation between the levels of serum sIL-2R and serum IL-6. There were significant and positive correlations between the levels of sIL-2R and the number of white blood cells and neutrophils. Conversely, there was a significantly negative correlation between the levels of serum sIL-2R and the number of lymphocytes.
As high levels of serum sIL-2R were recognized after abdominal operations, the proliferation of T lymphocytes might still be highly activated in a state of surgical stress, though it is popularly acceptable that surgical stress induces a suppression of cell-mediated immunity.
手术应激会引发多种生理功能的改变,包括细胞介导的免疫反应。已知白细胞介素-2受体(IL-2R)从活化T淋巴细胞上的特异性亲和膜受体释放出来,然后在血液中以IL-2Rα链的形式被检测到。血清可溶性IL-2R(sIL-2R)水平反映了活化T淋巴细胞的数量。本研究调查了腹部手术后血清sIL-2R水平的变化以及这些变化与其他细胞因子和淋巴细胞数量的关系。
本研究纳入了24例计划接受腹部手术的患者。在手术前以及术后第1、3、7和14天采集这些患者的血样。采用酶联免疫吸附测定法测量血清sIL-2R水平。
血清sIL-2R水平在术后第1天达到最大值,然后逐渐下降直至术后第14天。术后第1、3和7天的血清sIL-2R水平显著高于术前水平。血清sIL-2R水平与血清IL-6之间存在显著正相关。sIL-2R水平与白细胞和中性粒细胞数量之间存在显著正相关。相反,血清sIL-2R水平与淋巴细胞数量之间存在显著负相关。
由于腹部手术后血清sIL-2R水平升高,尽管普遍认为手术应激会导致细胞介导的免疫抑制,但在手术应激状态下T淋巴细胞的增殖可能仍处于高度活化状态。