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Baran SW, Perret-Gentil MI, Johnson EJ, Miedel EL, Kehler J. Rodent laparoscopy: Refinement for rodent drug studies and model development, and monitoring of neoplastic, inflammatory and metabolic diseases. Lab Anim 2011; 45:231-9. [DOI: 10.1258/la.2011.010027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Szczepan W Baran
- Veterinary Bioscience Institute, 292 Main Street, #300, Harleysville, PA 19438, USA
| | - Marcel I Perret-Gentil
- Laboratory Animal Resources Center, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Elizabeth J Johnson
- Veterinary Services for Putney, Inc, Putney, Inc, 400 Congress Street, Portland, ME 04101, USA
| | - Emily L Miedel
- University Laboratory Animal Resources, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - James Kehler
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
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Djaldetti M, Salman H, Bergman M, Djaldetti R, Bessler H. Phagocytosis--the mighty weapon of the silent warriors. Microsc Res Tech 2002; 57:421-31. [PMID: 12112425 DOI: 10.1002/jemt.10096] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Professional phagocytes, comprising polymorphonuclear neutrophils and monocyte/macrophage cells, play an important role in the host defense. Any defect in their function exposes the organism to microbial intruders terminating in fatal diseases. The functional responses of the phagocytes to bacterial and fungal infections include chemotaxis, actin assembly, migration, adhesion, aggregation, phagocytosis, degranulation, and reactive oxygen species production. Superoxide generation by phagocytic NADPH oxidase is an imperative step toward bacterial killing. Phagocytes participate in inflammatory reactions and exert tumoricidal activity. They are supported by serum factors such as immunoglobulins, cytokines, complement, the acute phase reactant C-reactive protein, production of antibacterial proteins, and others. In addition to their principal task to eliminate bacteria, they are engaged in removing damaged, senescent, and apoptotic cells. Engulfed cell debris, large particles such as latex beads, fat, and oil droplets, are examples of phagocytic activity illustrated in the present review with transmission and scanning electron microscope micrographs. Numerous factors, such as diseases and stressful conditions, affect the engulfing activity of the professional phagocytes. Our experience regarding the impaired phagocytic capacity of cells in patients with diabetes and chronic renal failure is discussed. The results obtained in our laboratory from experiments detecting the effect of strenuous physical exercise, hypothermia, fasting, and abdominal photon irradiation on the phagocytic capacity of human polymorphonuclear neutrophils and rat peritoneal macrophages are hereby summarized and the reports on those subjects in the recent literature are reviewed. A variety of assays are applied for quantifying phagocytosis. Flow cytometry based on incubation of phagocytic cells with fluorescent conjugated particles and measuring the amount of fluorescence as an indicator of the engulfing capacity of the cells is a useful method. A direct visualization of the ingested particles using light or electron microscopy is a valuable tool for estimation of phagocytic function. In our hands, the use of semithin sections of embedded phagocytes following their incubation with latex particles provided satisfactory results for measuring the total number of phagocytic cells, as well as the internalizing capacity of each individual cell. Microbiological assays, the nitroblue tetrazolium test, quantitation of antibody- and antigen-mediated phagocytosis, as well as methods reviewed in detail in other reports are additional applications for determination of this intricate process.
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Affiliation(s)
- Meir Djaldetti
- Laboratory for Immunology and Hematology Research, Rabin Medical Center, Golda Campus, Petah Tiqva, Israel.
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Romeo C, Cruccetti A, Turiaco A, Impellizzeri P, Turiaco N, Di Bella C, Merlino MV, Cifalà S, Basile M, Gentile C, Salpietro DC. Monocyte and neutrophil activity after minor surgical stress. J Pediatr Surg 2002; 37:741-4. [PMID: 11987091 DOI: 10.1053/jpsu.2002.32268] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE Surgical stress produces changes in the immune status of patients. In adults, major surgery causes immunosuppression, whereas minor operations stimulate immune responses. In children, the immunologic response to surgery has not been elucidated completely. The authors investigated the effects of minor surgery on immune response by analyzing neutrophil and monocyte phagocytosis and oxidative burst activity. METHODS Sixteen children undergoing elective minor surgery were enrolled. Blood samples were collected before the operation (at time of induction of anesthesia), at the end of operation, and 72 hours after surgery. Neutrophil and monocyte phagocytosis and oxidative burst activity were studied using a flow cytometric method. RESULTS Phagocytosis and oxidative burst increased significantly at the end of the operation, both in neutrophils (7.4% and 14.3%, respectively) and monocytes (11.6% and 27%, respectively). The increase was only significant for monocytes (17.5%) 72 hours after surgery. White cell count did not show any significant changes. There was no significant correlation between phagocytosis, oxidative burst activity, and white cell count or neutrophil and monocyte count. CONCLUSIONS This study shows that minor surgery in children induces immune activation by increasing neutrophil and monocyte phagocytosis and oxidative burst activity. Further studies are required to understand the molecular basis of these findings.
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The effect of lidocaine on neutrophil respiratory burst during induction of general anaesthesia and tracheal intubation. Eur J Anaesthesiol 2001. [DOI: 10.1097/00003643-200108000-00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mathiak G, Szewczyk D, Abdullah F, Ovadia P, Feuerstein G, Rabinovici R. An improved clinically relevant sepsis model in the conscious rat. Crit Care Med 2000; 28:1947-52. [PMID: 10890646 DOI: 10.1097/00003246-200006000-00043] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop an improved small animal experimental paradigm that more closely mimics human sepsis. DESIGN Prospective, randomized, controlled animal study. SETTING Medical school research laboratory. SUBJECTS Male Sprague-Dawley rats (280-320 g). INTERVENTIONS We monitored the hemodynamic, hematologic, and biochemical consequences of abdominal sepsis produced by intraperitoneal implantation of a fibrin clot containing Escherichia coli in conscious, antibiotic-treated, rats. MEASUREMENTS AND MAIN RESULTS Similar to human sepsis, the implanted, infected clot (LD50 = 5-7 x 10(8) colony forming units/mL, n = 6) elevated cardiac index (>7% vs. sterile clot, p < .05, at 4 hrs), whereas mean arterial pressure and heart rate remained unaffected. The total peripheral resistance index and stroke volume index tended to decrease and increase, respectively. In contrast, an intravenous bolus injection of endotoxin (LD50 of E. coli lipopolysaccharide = 5.6 mg/kg, n = 7), the most commonly used sepsis model, induced profound hypodynamic responses manifested by a 27% decrease (vs. endotoxin vehicle, p < .01) in cardiac index, a 28% increase in the total peripheral resistance index (p < .01), and a 33% decrease in the stroke volume index (P < .01). The infectious peritonitis model also displayed dose-dependent thrombocytopenia (<61%, p < .05), leukopenia (<60%, p < .05), and mortality rate (50% at 5-7 x 10(8) colony forming units/mL, p < .05) with a minimally elevated serum tumor necrosis factor-alpha level (145 vs. 12 +/- 6 pg/mL in controls, p < .05). CONCLUSION This rodent model of antibiotic-treated, intra-abdominal infection features key characteristics of clinical sepsis. Although the hyperdynamic response observed in septic patients undergoing resuscitation was not clearly elicited, this paradigm better mimics clinical sepsis compared with the commonly used endotoxin model. Thus, utilization of this paradigm may provide additional opportunities to explore mechanisms of sepsis and to examine novel therapeutics.
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Affiliation(s)
- G Mathiak
- Department of Surgery, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA, USA
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Gitzelmann CA, Mendoza-Sagaon M, Talamini MA, Ahmad SA, Pegoli W, Paidas CN. Cell-mediated immune response is better preserved by laparoscopy than laparotomy. Surgery 2000; 127:65-71. [PMID: 10660760 DOI: 10.1067/msy.2000.101152] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study compares the effects of carbon dioxide pneumoperitoneum versus laparotomy on cellular-mediated immune response in a murine model. METHODS Sixty-eight female C3H/He mice were sensitized to keyhole limpet hemocyanin (KLH) and to a mouse mammary carcinoma cell line (MC2) before surgery. Animals were randomized into 4 groups: group I, anesthesia (control); group II, pneumoperitoneum with carbon dioxide; group III, extraperitoneal wound; group IV, laparotomy. All animals were challenged subsequently with KLH and MC2 tumor cells. Delayed-type hypersensitivity skin reaction (DTH) to KLH was measured on postoperative days (PODs) 1, 2, 4, and 5. Tumor growth was assessed weekly as an indicator of postoperative cellular immune response. RESULTS Compared with preoperative values, postoperative DTH skin reactions were significantly less for all PODs in groups III and IV (P < .05), on POD 1 and 4 in group II (P < .05) and POD 4 for group I (P < .05). Group IV showed significantly fewer DTH skin reactions for all PODs compared with groups I and II (P < .05) and all PODs except on day 2 compared with group III (P < .05). Tumor growth was significantly increased at postoperative week 2 (n = 3/17 mice) and 3 (n = 4/17 mice) in group IV, when compared with groups I and II (P < .05). CONCLUSIONS Cellular immunity is preserved after carbon dioxide pneumoperitoneum compared with extraperitoneal incisions and laparotomy as measured by DTH and the ability to reject an immunogenictumor.
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Kampen GT, Poulsen LK, Nielsen HJ, Schulze S, Petersen LJ. IgE levels in surgery: effect of ranitidine and prednisolone. Allergy 1999; 54:171-6. [PMID: 10221441 DOI: 10.1034/j.1398-9995.1999.00775.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Immunoglobulin E (IgE) is important in allergic reactions and in host defense against parasites. IgE may also participate in the acute-phase response to physical stress. This study aimed to determine whether major abdominal surgery induced increased serum IgE levels, and whether treatment with ranitidine or prednisolone influenced the IgE response to surgery. METHODS For assessment of the IgE response to surgery and the effect of ranitidine, 24 patients scheduled for major abdominal surgery were randomized to receive either perioperative treatment with ranitidine or no treatment. To evaluate the effect of glucocorticoids, 24 patients undergoing major elective abdominal surgery were randomized to receive preoperative treatment with either prednisolone or placebo. IgE levels were determined in serum samples drawn pre- and postoperatively. RESULTS In the ranitidine study, both the control group and the ranitidine-treated group displayed a postoperative increase (P<0.001) of serum IgE. In the prednisolone study, a postoperative increase (P<0.05) of serum IgE was detected in the placebo group. No significant increase was found in the prednisolone-treated group. CONCLUSIONS Major abdominal surgery induces an increase of serum IgE. This increase can be prevented by preoperative treatment with prednisolone, but not with ranitidine.
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Affiliation(s)
- G T Kampen
- Laboratory of Medical Allergology, Allergy Unit, National University Hospital, Copenhagen, Denmark
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Salman H, Bergman M, Bessler H, Alexandrova S, Beilin B, Djaldetti M. Effect of sodium thiopentone anesthesia on the phagocytic activity of rat peritoneal macrophages. Life Sci 1998; 63:2221-6. [PMID: 9870707 DOI: 10.1016/s0024-3205(98)00506-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To elucidate the effect of sodium thiopentone anesthesia on the function of phagocytic cells, albino rats were anesthetized with 60 mg/kg. of sodium thiopentone. After 90 min., peritoneal macrophages were harvested and their capacity for superoxide anion generation was detected. Following anesthesia for 90 min. latex particles were injected intraperitoneally, and after additional 30 min. the macrophages were derived, embedded in agar and the number of cells engaged in phagocytosis, as well as the number of latex particles engulfed by each individual cell were counted in semi-thick sections. Macrophages of anesthetized animals showed a statistically significant decrease of both superoxide anion generation and mean number of phagocytic cells, and engulfed fewer particles than those of the controls. Similar results were obtained following incubation of the cells with sodium thiopentone in vitro. The serum corticosterone level in anesthetized rats was significantly higher than that of the control animals. The results indicate that impaired phagocytosis following anesthesia induced by sodium thiopentone, in addition to alterations of the immune system caused by surgical trauma, may be one of the reasons for increased susceptibility to infections of surgical patients during the postoperative period.
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Affiliation(s)
- H Salman
- Department of Medicine C, Rabin Medical Center, Golda Campus, Petah Tiqva, Israel
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10
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Mendoza-Sagaon M, Gitzelmann CA, Herreman-Suquet K, Pegoli W, Talamini MA, Paidas CN. Immune response: effects of operative stress in a pediatric model. J Pediatr Surg 1998; 33:388-93. [PMID: 9498424 DOI: 10.1016/s0022-3468(98)90469-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study is to delineate the effect of different operative procedures on the cell-mediated immune response in a pediatric animal model using the delayed type hypersensitivity (DTH) skin test. METHODS Sprague Dawley rats (1 week old) were sensitized against keyhole limpet hemocyanin (KLH). Animals were challenged 2 weeks later by an intradermal injection of KLH (0.3 mg) in sterile saline. Rats with positive DTH skin reactions at 24 and 48 hours after challenge (baseline) were divided randomly into five groups (n = 10 each): group I, unmanipulated control; group II, anesthesia; group III, anesthesia and midline extraperitoneal incision; Group IV, anesthesia and laparoscopy (pneumoperitoneum with carbon dioxide); Group V, anesthesia and midline laparotomy. Before each procedure (day 0) and on postoperative days 3 and 6, animals were again challenged intradermally with KLH (0.3 mg). DTH skin reaction was evaluated 24 and 48 hours later. RESULTS A statistically significant difference (P < .05) in DTH skin reaction at 24 and 48 hours was observed between postoperative days 1 to 5 in the extraperitoneal and laparotomy groups with respect to baseline and the control group. Statistically significant differences were found in postoperative days 1, 4, and 5 between laparoscopy and laparotomy. The laparoscopy group showed a statistically significant decrease in DTH skin induration on postoperative day 2 when compared with the control group. At postoperative day 7 and 8 there was no statistical difference in DTH skin response comparing baseline values or between groups. CONCLUSIONS These results suggest that in a pediatric animal model, abdominal surgical procedures accompanied by extensive tissue dissection produce a cellular immunosuppression, lasting up to 7 days, which is not observed in less invasive procedures. Observations concerning lesser immunosuppressive effects of laparoscopy when compared with laparotomy in adult models, as previously described by our laboratory, were also found in this pediatric model.
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Affiliation(s)
- M Mendoza-Sagaon
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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Merry C, Puri P, Reen DJ. Effect of major surgery on neutrophil chemotaxis and actin polymerization in neonates and children. J Pediatr Surg 1997; 32:813-7. [PMID: 9200076 DOI: 10.1016/s0022-3468(97)90626-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors have examined the effect of major surgery in neonates and older children on neutrophil (PMN) chemotaxis and on actin polymerization, an essential early step in PMN movement. Isolated PMNs from the following subjects were studied: healthy adult volunteers (n = 28), healthy newborns (n = 21), newborns undergoing major surgery (n = 7), and older infants and children undergoing major surgery (n = 14). Chemotaxis was measured by a micropore filter assay, and actin polymerization was measured by flow cytometry. Blood samples from surgical patients were obtained preoperatively, hourly during the procedure, immediately postoperatively, and 48 hours after surgery. Mean preoperative newborn PMN chemotaxis was similar to that of healthy newborn PMN, and mean preoperative PMN chemotaxis in children was similar to that of healthy adults. There were no significant alterations in PMN chemotaxis during or after major surgery in neonates or children. Peak PMN actin polymerization, after stimulation with formyl methionyl leucyl phenylalanine (FMLP) (10 nm), was significantly diminished in healthy neonates compared with adults (P < .005). Preoperative surgical neonates had similar peak PMN actin polymerization levels to those of healthy newborns, and older preoperative children had similar levels to adults. PMN actin polymerization did not significantly change during or after major surgery. Despite reductions in PMN chemotaxis and actin polymerization in healthy neonates, there is no further impairment of these PMN functions during or after major surgery. Our data suggest that PMN chemotactic function is resistant to the stress of uncomplicated major surgery in neonates and children.
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Affiliation(s)
- C Merry
- Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland
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Erskine R, Janicki PK, Neil G, James MF. Spinal anaesthesia but not general anaesthesia enhances neutrophil biocidal activity in hip arthroplasty patients. Can J Anaesth 1994; 41:632-8. [PMID: 8087913 DOI: 10.1007/bf03010005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to compare neutrophil cidal activity during general or spinal anaesthesia. Assays were performed on neutrophils extracted from the blood of patients after surgery had been under way for one hour. First, the ability of the neutrophils to kill a standard laboratory strain of S. aureus was examined. Neutrophils extracted from the blood during surgery in the spinal anaesthetic group and incubated with the staphylococci for one hour killed twice as many bacteria than those from two groups of patients that received halothane or isoflurane general anaesthesia (P < 0.05). This effect persisted, to a lesser extent, in the spinal group neutrophils after two hours of incubation with the bacteria. Second, neutrophils from patients under the same conditions of surgery and anaesthesia were tested to examine the effect of the different anaesthetic techniques on neutrophil biocidal mechanisms. Neutrophils extracted during surgery in the spinal group released more superoxide in response to phorbol-12-myristate-13-acetate (PMA) than those from both groups of patients that received general anaesthesia (P < 0.05). It is concluded that there is an increased state of reactivity of the neutrophil cell membrane NADPH oxidase system in patients receiving spinal anaesthesia than in patients receiving general anaesthesia.
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Affiliation(s)
- R Erskine
- Anglo American Anaesthetic Research Laboratory, University of Cape Town, South Africa
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13
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Boileau S, Hoffmann S, Janot C, Grosdidier G, Laxenaire MC. [Comparative study of immunologic consequences of autotransfusion and homologous transfusion in lung cancer surgery]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1993; 12:251-9. [PMID: 8250362 DOI: 10.1016/s0750-7658(05)80650-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A study was carried out to determine the effects of transfusion with either autologous or homologous blood in 35 patients with lung cancer undergoing lung surgery. The patients were randomly allocated to two groups, "allo" receiving homologous blood (n = 10), and "auto" receiving autologous blood only (n = 13). A third control group included the patients (n = 12) who had not required any blood. In patients of "auto" group, two blood removals of 7 ml.kg-1 each were performed, provided their haemoglobin concentration was over 110 g.l-1 and their haematocrit over 34%. The following parameters were studied at t-1 (the day of inclusion), t0 (just before surgery and transfusion), t1 (one week after surgery), and t2 (one month later): haematocrit and haemoglobin concentration; IgG, IgA and IgM concentrations; polymorphonuclear and neutrophil leucocyte and lymphocyte numbers, lymphocyte subpopulations (CD4/CD8), activated natural killers (NK), polymorphonuclear leukocyte chemotaxis and chemoluminescence. Anaesthesia and surgery initiated initiated an early decrease in immunity in all three groups. The immune profile, and its time course in patients who received autologous blood only was similar to that of those who were not transfused at all. On the other hand, homologous blood transfusion seems to modify the recipient's non specific immune system. In group "allo", a decrease occurred in the number of auxiliary lymphocytes CD4, an increase in suppressor lymphocyte numbers CD8, with an increase in the CD4/CD8 ratio, and no increase in NK activity. These data suggest that autologous transfusion is well tolerated in cancer patients undergoing surgery.
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Affiliation(s)
- S Boileau
- Département d'Anesthésie-Réanimation Chirurgicale, Hôpital Central, Nancy
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14
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Lilius EM, Marnila P. Photon emission of phagocytes in relation to stress and disease. EXPERIENTIA 1992; 48:1082-91. [PMID: 1473571 DOI: 10.1007/bf01947995] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Phagocytes, the first-line cells of the body's defence mechanisms against invading pathogens, kill microorganisms by means of lysosomal degradative enzymes and highly toxic reactive oxygen intermediates. The reactive oxygen compounds are produced, in a process called the 'respiratory burst', by the NADPH oxidase complex in plasma membranes, and by myeloperoxidase in phagolysosomes after degranulation. These processes generate electronically excited states which, on relaxation, emit photons, giving rise to phagocyte chemiluminescence (CL). This paper describes the conditions for the measurement of CL, and reviews the activity of phagocytes from individuals undergoing stress or disease. The capability of phagocytes to emit photons reflects remarkably well the pathophysiological state of the host. In many cases even the magnitude of the stress, the presence of a pathogen in the body, or the activity of the disease can be estimated. Physiological changes, e.g. in the reproductive cycle, can also be predicted.
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Affiliation(s)
- E M Lilius
- Department of Biochemistry, University of Turku, Finland
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Erskine R, Janicki PK, Ellis P, James MF. Neutrophils from patients undergoing hip surgery exhibit enhanced movement under spinal anaesthesia compared with general anaesthesia. Can J Anaesth 1992; 39:905-10. [PMID: 1451217 DOI: 10.1007/bf03008337] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The purpose of this research was to investigate whether the effects of regional anaesthesia on neutrophil migration differ from those due to general anaesthesia during major orthopaedic surgery in human patients. Eighteen patients underwent spinal or general anaesthesia (halothane or isoflurane) for surgery (six patients in each group). Blood samples were taken prior to induction of anaesthesia and after surgery was in progress for one hour. The movement of isolated neutrophils was measured in both samples in the chemotactic chamber toward lipopolysaccharide activated pooled serum. In addition plasma concentrations of catecholamines were determined in the blood samples. Neutrophils extracted from peripheral blood during spinal anaesthesia and surgery moved further towards a complement-derived attractant than neutrophils obtained from patients undergoing surgery under general anaesthesia with halothane or isoflurane and surgery (156.4 +/- 7.6 microns vs 114.3 +/- 6.1 microns or 119 +/- 8.4 microns respectively, P < 0.05). Increased concentrations of adrenaline were present in both general anaesthetic groups whereas the spinal group had lower concentrations than those prior to anaesthesia and surgery. It is considered unlikely that these differences in neutrophil reactivity are due to the direct effects of anaesthetic agents employed. The effects are likely to be the result of differing effects of spinal anaesthesia on the stress response or immunological mediators.
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Affiliation(s)
- R Erskine
- Department of Anaesthetics, Medical School, University of Cape Town
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16
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Vanoli M. Drug-induced immunodeficiencies. Pharmacol Res 1992; 26 Suppl 2:88-93. [PMID: 1409336 DOI: 10.1016/1043-6618(92)90613-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M Vanoli
- Institute of Internal Medicine, Infectious Diseases and Immunopathology, University of Milan, I.R.C.C.S. Ospedale Maggiore di Milano, Italy
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Abstract
An immunosuppressed state develops following traumatic injury, which makes patients more prone to develop infection. A variety of disturbances accompany injury that affect both specific and nonspecific components of host defense. Many clinical studies have attempted to evaluate the many deficits that follow injury and place the patient at a higher risk for infection. Several components of host defense are affected simultaneously and include (1) cellular changes (decreased activation of T-lymphocyte subsets with decreased helper cells, increased suppressor T-cell function, increased but abnormal activity of macrophages, activation of polymorphonuclear leukocytes with depressed chemotaxis and killing); (2) depressed nonspecific and specific serum immunity (e.g., depressed fibronectin and immunoglobulin levels); (3) the presence of altered cytokine levels (interleukin-1 [IL-1], IL-2, IL-6, tumor necrosis factor) levels; (4) ongoing serum proteolytic activity; and (5) the generation of serum suppressive peptides. An in-depth understanding of the deficits that occur following injury in host defense will provide the basis for therapeutic intervention.
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Affiliation(s)
- David B. Hoyt
- Department of Surgery, Division of Trauma, University of California, San Diego, San Diego, CA
| | - A. Nuri Ozkan
- Department of Surgery, Division of Trauma, University of California, San Diego, San Diego, CA
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Higashiyama H, Egawa H, Iwata S, Wada Y, Shimahara Y, Sasada M, Mori K, Ozawa K. Impaired polymorphonuclear leucocyte function in patients undergoing hepatectomy: adenylate energy charge and superoxide anion production in relation to hepatic mitochondrial redox state. Br J Surg 1990; 77:1224-8. [PMID: 2174706 DOI: 10.1002/bjs.1800771111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Patients undergoing hepatectomy have an increased susceptibility to infection. We therefore studied the energy metabolism of the polymorphonuclear leucocyte (PMN), focusing on energy charge and function, especially superoxide anion (O2-) generation, in relation to the hepatic mitochondrial redox state. By labelling the PMN adenine nucleotide pool with radioactive adenine and by superoxide dismutase-inhibitable reduction of ferricytochrome c, the energy charge and O2- production was measured in 18 patients with hepatoma (non-cirrhotic, seven; cirrhotic, 11) undergoing hepatectomy. Their arterial ketone body ratios (KBRs), reflecting the hepatic mitochondrial redox potential, were above 0.7 before operation. After surgery, the 18 patients were divided into two groups: group A, KBR greater than 0.7, n = 10; and group B, KBR less than 0.7, n = 8. The energy charge and O2- release in group B decreased significantly from preoperative values (P less than 0.001 and P less than 0.01 respectively) and when compared with group A (P less than 0.05 and P less than 0.01 respectively). These results suggest that impaired hepatic energy metabolism (KBR less than 0.7) in hepatectomized patients leads to impaired energy charge and O2- production in the PMNs.
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Affiliation(s)
- H Higashiyama
- Second Department of Surgery, Faculty of Medicine, Kyoto University, Japan
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Polk HC, George CD, Hershman MJ, Wellhausen SR, Cheadle WG. The capacity of serum to support neutrophil phagocytosis is a vital host defense mechanism in severely injured patients. Ann Surg 1988; 207:686-92. [PMID: 3389936 PMCID: PMC1493541 DOI: 10.1097/00000658-198806000-00007] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The opsonic capacity of patient serum was studied in 43 trauma patients of whom 13 recovered uneventfully, 21 developed major infection, and nine died, mostly of infection. Blood samples were taken within 24 hours of injury. Fifteen patients were studied serially of whom 14 developed severe infection and/or died. Opsonic capacity was determined by flow cytometry and measured as the ability of normal neutrophils to phagocytose killed bacteria previously incubated with patient serum. The most dilute sera reflected changes for better and worse most clearly. On initial assessment, those who died of sepsis showed a 61% mean fluorescent intensity (MFI), which was significantly lower than the 99% MFI for those who survived infection (p less than 0.01) and the 78% MFI of those who developed no infection (p less than 0.05). Serial samples demonstrated a super serum response in four of seven patients surviving major sepsis but in none of the seven who died of infection.
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Affiliation(s)
- H C Polk
- Price Institute for Surgical Research, Department of Surgery, University of Louisville School of Medicine, Kentucky 40292
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