Ono Satoshi, Mochizuki Hidetaka
Department of Surgery I, National Defense Medical College, Tokorozawa, Japan.
Nihon Geka Gakkai Zasshi. 2003 Dec;104(12):822-7.
Suppression of cellular immunity secondary to decreased immunocyte function is one of the surgical stress-induced biological responses. Monocytes/macrophages, natural killer (NK) cells, lymphocytes, and neutrophils play an important role in this immune system. These immunity charge cells are expressed through various surface antigens, such as major histocompatibility complex (MHC) class antigens, T cell receptors, and the cytokines interferon-gamma, interleukin (IL)-2, and IL-12. MHC class II antigen expression of monocytes and the cytokine production of CD4+ T cells are decreased after surgical stress. In this immune-suppressed condition, patients after surgical stress can easily experience infectious complications, and therefore the up-regulation of the immune system is necessary to avoid those complications. Recently, the role of natural immunity as a defense system against infection has received attention. The discovery of Toll-like receptor families revealed how the macrophage system cells recognize microorganisms. Furthermore, liver natural killer(NK) cells and NK T cells are important to induce the Th1 immune response in bacterial peritonitis. In this manuscript, we explain the mechanism of immune suppression after surgical stress and the host defense against infection by analyzing cytokine production and surface membrane molecules in mononuclear cells.
免疫细胞功能下降继发的细胞免疫抑制是手术应激诱导的生物学反应之一。单核细胞/巨噬细胞、自然杀伤（NK）细胞、淋巴细胞和中性粒细胞在该免疫系统中起重要作用。这些免疫活性细胞通过各种表面抗原表达，如主要组织相容性复合体（MHC）类抗原、T细胞受体以及细胞因子干扰素-γ、白细胞介素（IL）-2和IL-12。手术应激后，单核细胞的MHCⅡ类抗原表达及CD4 + T细胞的细胞因子产生减少。在这种免疫抑制状态下，手术应激后的患者容易发生感染性并发症，因此上调免疫系统对于避免这些并发症是必要的。最近，天然免疫作为抗感染防御系统的作用受到了关注。Toll样受体家族的发现揭示了巨噬细胞系统细胞如何识别微生物。此外，肝脏自然杀伤（NK）细胞和NK T细胞对于在细菌性腹膜炎中诱导Th1免疫反应很重要。在本手稿中，我们通过分析单核细胞中的细胞因子产生和表面膜分子来解释手术应激后免疫抑制的机制以及宿主抗感染防御。
