The immune-enhancing effect of perioperative thymopentin administration in elderly patients undergoing major surgery.
The effects of perioperative administration of thymopentin (TP-5) on in vivo and in vitro measurements of cell-mediated immunity in elderly patients undergoing major surgery were investigated. A placebo-controlled study was conducted in 25 patients (mean age, 67 years) with congenital or acquired heart disease undergoing surgery with cardiopulmonary bypass. Patients were divided into three groups: Group 1 patients were given 50 mg of TP-5 subcutaneously two hours preoperatively. Group 2 patients were given 50 mg of TP-5 subcutaneously two hours preoperatively and 48 hours postoperatively. Group 3 patients were given placebo at corresponding times. Cell-mediated immunity measurements were the in vivo delayed-type hypersensitivity (DTH) response on day 0 and on day 7 to an antigen skin test battery. The in vitro studies included antigen cocktail-induced lymphocyte proliferation of peripheral blood mononuclear cells. The DTH response on day 7 after surgery was significantly suppressed in group 3 patients compared with the preoperative baseline value, while it remained unaltered in group 1 and 2 patients. There was a considerable difference of DTH measurements (number of positive antigen responses and sum of their mean diameters) between group 2 and 3 patients. Antigen cocktail-induced lymphocyte proliferation, following initial suppression in the majority of patients, was significantly different between the placebo group and patients in group 2 on day 7 after surgery. The data indicate that perioperative administration of TP-5 might be of considerable clinical utility in preventing a defective cellular immune response.
Faist
E
E
Department of Surgery, LM University, Munich, West Germany.
Ertel
W
W
Salmen
B
B
Weiler
A
A
Ressel
C
C
Bolla
K
K
Heberer
G
G
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000368:Aged; D002315:Cardiopulmonary Bypass; D002986:Clinical Trials as Topic; D004342:Drug Hypersensitivity / Q000517:prevention & control; D005260:Female; D006330:Heart Defects, Congenital / Q000276:immunology / Q000601:surgery*; D006331:Heart Diseases / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D066298:In Vitro Techniques; D007213:Indomethacin / Q000493:pharmacokinetics; D007279:Injections, Subcutaneous; D007376:Interleukin-2 / Q000096:biosynthesis; D008213:Lymphocyte Activation / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage / Q000493:pharmacokinetics*; D011897:Random Allocation; D012882:Skin Tests; D013601:T-Lymphocytes / Q000276:immunology*; D016305:Thymopentin; D013946:Thymopoietins / Q000008:administration & dosage / Q000493:pharmacokinetics*; D013951:Thymus Hormones / Q000493:pharmacokinetics*; D013997:Time Factors
D000276:Adjuvants, Immunologic; D007376:Interleukin-2; D010446:Peptide Fragments; D013946:Thymopoietins; D013951:Thymus Hormones; D016305:Thymopentin; D007213:Indomethacin