Major surgery suppresses maximal production of helper T-cell type 1 cytokines without potentiating the release of helper T-cell type 2 cytokines.
BACKGROUND
Major surgery is known to suppress T-cell function; however, its differential effects on the production of helper T-cell type 1 (T(H)1) and type 2 (T(H)2) cytokines remains unknown.


OBJECTIVE
To measure the production patterns of T(H)1 (interleukin 2 [IL-2] and interferon gamma) and T(H)2 (IL-4 and IL-10) cytokines following major surgery.


METHODS
A cohort study of patients (both active and former members of the armed forces) at a military hospital.


METHODS
Aortic surgery or carotid endarterectomy and measurement of serum IL-6 levels by enzyme-linked immunosorbent assay.


METHODS
Unstimulated and stimulated intracellular levels of IL-2, IL-4, IL-10, and interferon gamma in CD4+, CD8+, and gammadelta+ T cells and serum IL-6 levels immediately before and for 2 days after aortic surgery or carotid endarterectomy.


RESULTS
No unstimulated production of T(H) or T(H)2 cytokines was detected. Stimulated intracellular levels of IL-2 and interferon gamma were significantly depressed during the postoperative period in all T-cell subsets in both patient groups. There were no postoperative increases in stimulated IL-4 or IL-10 levels.


CONCLUSIONS
Major surgery suppresses the potential responses of T(H)1 cytokines without enhancing production of T(H)2 cytokines.
D000368:Aged; D001011:Aorta / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis*; D007378:Interleukins / Q000096:biosynthesis*; D008297:Male; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*