[Postoperative immunosuppression--a physiological process and source of complications. Minireview].
Postoperative immunosuppression reflects non-specific neurohumoral stress responses to surgical trauma. Surgical stress in the early stage is characterised by a dysbalance of the adrenocortical response, the index of the formation of glucocorticoids and dehydroepiandrosterone is shifted to the glucocorticoids. This non-specific hormonal response has an impact on the balance between TH1 and TH2 lymphocyte response. Inhibition of the TH1 response occurs, the clinical reflection of which is a decline of cell-mediated immunity. Postoperative immunosuppression and dysbalance of cell-mediated and humoral immunity are physiological processes, part of the neurohumoral stress response to surgical trauma. Its potential pathological consequences, although proved so far only experimentally, make it on the one hand an important factor for evaluation of the risk of postoperative complications and on the other hand a possible of object of therapeutic intervention in oncological or high risk patients.
I. chirurgická klinika 1. LF UK, Praha. maruna@lf1.cuni.cz
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Maruna
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Gürlich
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Frasko
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Chachkhiani
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D016207:Cytokines / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D015213:Neuroimmunomodulation / Q000502:physiology; D011183:Postoperative Complications / Q000276:immunology*; D013312:Stress, Physiological / Q000209:etiology / Q000276:immunology*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
D000276:Adjuvants, Immunologic; D016207:Cytokines