Oka M, Hirazawa K, Yamamoto K, Iizuka N, Hazama S, Suzuki T, Kobayashi N
Department of Surgery II, Yamaguchi University School of Medicine, Japan.
Ann Surg. 1996 Apr;223(4):434-40. doi: 10.1097/00000658-199604000-00013.
The authors determined whether the decrease in lymphocytes after surgery is related to apoptosis.
Surgery induces a profound but transient depletion of circulating lymphocytes, However, the mechanism underlying this phenomenon is unclear.
Peripheral blood mononuclear cells were obtained from 18 patients before and after elective surgery and studied for morphologic and biochemical markers of apoptosis, DNA fragmentation, and Fas expression.
The DNA staining of peripheral blood mononuclear cells obtained after surgery, which had been cultured for 24 hours in vitro, showed chromatin condensation and fragmentation of cells into collapsed spheres. Moreover, DNA isolated from these peripheral blood mononuclear cells formed a ladder of oligonucleosomal fragments. However, peripheral blood mononuclear cells obtained before surgery showed neither of these changes. The observation that none of these apoptotic cells ingested latex suggested that they were of lymphocytic origin. Fas-positive lymphocytes increased significantly 2 hours after the start of surgery and returned to preoperative levels by postoperative day 7. Anti-Fas antibody augmented apoptosis, whereas ZB4, a Fas antagonist, inhibited apoptosis in lymphocytes after surgery.
These results indicate that circulating lymphocytes in the early perioperative period are susceptible to Fas-mediated apoptosis, which may cause depletion of circulating lymphocytes after surgery.
作者确定术后淋巴细胞减少是否与细胞凋亡有关。
手术会导致循环淋巴细胞显著但短暂的减少，然而，这一现象背后的机制尚不清楚。
从18例择期手术患者术前及术后采集外周血单个核细胞，研究细胞凋亡的形态学和生化标志物、DNA片段化及Fas表达。
术后获取的外周血单个核细胞在体外培养24小时后，DNA染色显示染色质浓缩，细胞破碎成塌陷的球体。此外，从这些外周血单个核细胞中分离出的DNA形成了寡核小体片段阶梯。然而，术前获取的外周血单个核细胞未出现上述任何变化。这些凋亡细胞均未吞噬乳胶的观察结果表明它们起源于淋巴细胞。手术开始2小时后，Fas阳性淋巴细胞显著增加，至术后第7天恢复到术前水平。抗Fas抗体增强细胞凋亡，而Fas拮抗剂ZB4抑制术后淋巴细胞凋亡。
这些结果表明围手术期早期循环淋巴细胞易受Fas介导的细胞凋亡影响，这可能导致术后循环淋巴细胞减少。
