Department of Surgery, University of Florida College of Medicine, Shands Hospital, Box 100286, Gainesville, FL 32610-0286, USA.
J Clin Immunol. 2009 Sep;29(5):568-81. doi: 10.1007/s10875-009-9291-y. Epub 2009 Apr 22.
Patients undergoing major hepatectomy are at increased risk for post-operative morbidity and mortality, and changes in the phenotype of effector cells may predispose these patients to infectious sequelae.
To better understand post-hepatectomy immune responses, peripheral blood from 15 hepatectomy patients was drawn immediately before and after liver resection and on post-operative days 1, 3, and 5. Circulating monocytes and dendritic cells were analyzed by flow cytometry for quantity, phenotype, activation status, human leukocyte antigen DR (HLA-DR) expression, and toll-like receptor-2 and -4 expression.
Major hepatectomy increased the numbers of activated CD16(bright) blood monocytes and the percentage of activated dendritic cells, although monocyte HLA-DR expression was reduced. These results may represent both dysfunctional antigen presentation and pending anergy, as well as cellular priming of immune effector cells. Better understanding of the alterations in innate immunity induced by hepatectomy may identify strategies to reduce infectious outcomes.
接受大肝切除术的患者术后发病率和死亡率增加，效应细胞表型的变化可能使这些患者易发生感染后遗症。
为了更好地了解肝切除术后的免疫反应，在肝切除术前、术后第 1、3 和 5 天从 15 例肝切除术患者中抽取外周血。通过流式细胞术分析循环单核细胞和树突状细胞的数量、表型、激活状态、人类白细胞抗原 DR（HLA-DR）表达和 Toll 样受体-2 和 -4 表达。
大肝切除术增加了活化的 CD16（bright）血单核细胞数量和活化树突状细胞的百分比，尽管单核细胞 HLA-DR 表达减少。这些结果可能代表抗原呈递功能障碍和即将发生的无能，以及免疫效应细胞的细胞启动。更好地了解肝切除术后固有免疫的改变可能有助于确定减少感染结果的策略。
