Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland.
Department of Surgical Oncology, Regional Specialist Hospital, Wroclaw, Poland.
Sci Rep. 2018 Jun 14;8(1):9126. doi: 10.1038/s41598-018-27245-z.
Interleukin-7 is critical for T-cell development and displays antimicrobial and antitumor properties. It is referred to as a "critical enhancer of protective immunity". However, there is no information on interleukin-7 dynamics following colorectal surgery. Moreover, although robot-assisted surgery is gaining popularity, data on the immune response to it is almost non-existent. In this prospective non-randomized case-control study we found interleukin-7 dynamics to differ following robot-assisted and open approach and to affect postoperative immunity. Linear increases were seen in the robotic group while a cubic pattern with a maximum at 8 h in the open one. Low preoperative interleukin-7 was associated with developing surgical site infection. In turn, higher preoperative interleukin-7 was associated with preserved immune function: less pronounced drop in lymphocyte count and higher Δlymphocyte/Δneutrophil ratio in patients undergoing robotic surgery. The changes in other cytokines, namely, interleukin-12(p70), TNFα, interferon-γ, and interleukin-10 were independently associated with interleukin-7 dynamics. In turn, relative changes in interleukin-7 were independent predictors of changes in interferon-γ, key cytokine of favourable Th1 immune response. Taken together, we demonstrated different perioperative dynamics of interleukin-7, which may contribute to favourable outcomes following robotic colorectal surgery including lower incidence of surgical site infections, milder surgery-induced lymphopenia, and beneficial interferon-γ dynamics.
白细胞介素-7 对 T 细胞的发育至关重要，具有抗微生物和抗肿瘤特性。它被称为“保护性免疫的关键增强剂”。然而，关于结直肠手术后白细胞介素-7 的动态变化还没有信息。此外，尽管机器人辅助手术越来越受欢迎，但关于其免疫反应的数据几乎不存在。在这项前瞻性非随机病例对照研究中，我们发现白细胞介素-7 的动力学在机器人辅助和开放方法下有所不同，并影响术后免疫。机器人组呈线性增加，而开放组呈 8 小时的立方模式，达到最大值。术前白细胞介素-7 水平低与手术部位感染的发生有关。相反，较高的术前白细胞介素-7 与保留免疫功能有关：机器人手术患者的淋巴细胞计数下降幅度较小，淋巴细胞/中性粒细胞比值升高。其他细胞因子，即白细胞介素-12(p70)、TNFα、干扰素-γ 和白细胞介素-10 的变化与白细胞介素-7 的动力学独立相关。反过来，白细胞介素-7 的相对变化是干扰素-γ变化的独立预测因子，干扰素-γ 是有利的 Th1 免疫反应的关键细胞因子。总之，我们证明了白细胞介素-7 的不同围手术期动力学，这可能有助于机器人结直肠手术后的良好结局，包括降低手术部位感染的发生率、手术引起的淋巴细胞减少症较轻以及有益的干扰素-γ 动力学。
