title: Induction of Fas-mediated apoptosis on circulating lymphocytes by surgical stress.
abstract: OBJECTIVE
  The authors determined whether the decrease in lymphocytes after surgery is related to apoptosis.
  
  
  BACKGROUND
  Surgery induces a profound but transient depletion of circulating lymphocytes, However, the mechanism underlying this phenomenon is unclear.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery II, Yamaguchi University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Oka
authors.forename: K
authors.initials: K
authors.lastname: Hirazawa
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: N
authors.initials: N
authors.lastname: Iizuka
authors.forename: S
authors.initials: S
authors.lastname: Hazama
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000368:Aged; D017209:Apoptosis / Q000502:physiology*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D011184:Postoperative Period; D013312:Stress, Physiological / Q000097:blood / Q000503:physiopathology*; D013514:Surgical Procedures, Operative; D019014:fas Receptor / Q000502:physiology*
chemical_list: D019014:fas Receptor