Original ArticlesDownregulation of T helper type 1 immune response and altered pro-inflammatory and anti-inflammatory T cell cytokine balance following conventional but not laparoscopic surgery1
Section snippets
Patients
In a prospective, nonrandomized study that was approved by the Technical University of Munich Ethical Committee, we analyzed the immune functions of 26 patients submitted to laparoscopic cholecystectomy (LCE) and 17 patients undergoing conventional cholecystectomy (CCE) for symptomatic cholecystolithiasis at the Surgical Department of the Technical University of Munich. Mean age for the laparoscopic group was 46.0 years (± 2.0, range 30 to 72) for 17 women and 9 men. For CCE, mean age was
Results
To evaluate the effect of minimally invasive surgery on Th1 and Th2 cell function, secretion of the cytokines IFN-γ, IL-2, and IL-4 before and after laparoscopic or open cholecystectomy was determined. In addition, TNF-α and IL-10 were measured to compare the effects of laparoscopic and open surgery on the balance of pro- and anti-inflammatory cytokines secreted by T cells. To detect functional alterations intrinsic to T cells and to exclude that the activity of antigen-presenting cells might
Comments
Among CD4+ T lymphocytes, Th1 and Th2 phenotypes may be distinguished.14 Th1 cells are mainly characterized by secretion of IFN-γ and IL-2 and induce cell-mediated immune responses. Th2 cells preferentially secrete the cytokines IL-4, IL-5, IL-6, and IL-13; and their activation favors humoral immune responses.15, 16 After major conventional surgery, our previously published results showed that IFN-γ and IL-2 secretion was reduced in the early postoperative phase, reflecting impaired function of
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This work was supported by DFG grants Si 208/5-1 and Si 208/5-4 to the clinical research group, “Immunosuppression und Postoperative Sepsis.”