Sedman P C, Ramsden C W, Brennan T G, Giles G R, Guillou P J
University Department of Surgery, St. James's University Hospital, Leeds, UK.
Br J Surg. 1988 Oct;75(10):976-81. doi: 10.1002/bjs.1800751012.
General surgical procedures are followed by a period of generalized immunosuppression that may favour the deposition of metastases seeded at operation in patients with malignant disease. In an attempt to prevent the suppression of host-antitumour immune mechanisms following surgery we have studied the immunological effects of low-dose perioperative interferon-alpha (r-HuIFN alpha). Patients were randomly allocated pre-operatively to the control (n = 15) or treatment group (n = 15). Patients in the treatment arm received a 1-week course of subcutaneous recombinant human interferon-alpha 2a (Roferon-A) at a dose of 2 megaunits daily starting on the evening before surgery. Natural killer cell, lymphokine activated killer cell cytotoxicities and endogenous interleukin 2 production were measured 1 day before surgery and on the first, third, fifth and tenth postoperative days. Treatment with r-HuIFN alpha did not prevent the postoperative impairment of interleukin 2 production or lymphokine activated killer cell cytotoxicity. However it prevented the fall in natural killer cell activity normally observed following surgery. This may have important consequences in controlling metastatic dissemination of tumour in this vulnerable period.
普通外科手术后会有一段全身性免疫抑制期,这可能有利于恶性疾病患者手术时播散的转移灶的沉积。为了防止手术后宿主抗肿瘤免疫机制受到抑制,我们研究了围手术期低剂量α-干扰素(r-HuIFNα)的免疫效应。患者在术前被随机分为对照组(n = 15)和治疗组(n = 15)。治疗组患者从手术前一晚开始,接受为期1周的皮下注射重组人α-干扰素2a(罗扰素)治疗,剂量为每日2百万单位。在手术前1天以及术后第1、3、5和10天测量自然杀伤细胞、淋巴因子激活的杀伤细胞的细胞毒性以及内源性白细胞介素2的产生。r-HuIFNα治疗并不能防止术后白细胞介素2产生或淋巴因子激活的杀伤细胞细胞毒性的损害。然而,它防止了通常在手术后观察到的自然杀伤细胞活性的下降。这在控制肿瘤在这个脆弱时期的转移扩散方面可能具有重要意义。