Adaptive immunity is severely impaired by open-heart surgery.
OBJECTIVE
The influence of open-heart surgery on antigen-specific immunity, also called adaptive immunity, remains to be clarified. We explored the effects of open-heart surgery on adaptive immunity.


METHODS
In 8 consecutive adult patients undergoing elective cardiac surgery with cardiopulmonary bypass, we measured the T cell-response to purified protein derivative (PPD) antigen perioperatively. We separately measured the proliferation of T cells and the antigen presentation of antigen-presenting cells (APCs) using a cross-reaction system.


RESULTS
T cell response to PPD antigen was severely impaired by open-heart surgery. Compared to preoperative values, T cell response to PPD antigen fell to 5.7 +/- 4.4% immediately after surgery, 4.5 +/- 3.2% on postoperative day (POD) 1, to 22.4 +/- 24.6% on POD 3 and to 50.1 +/- 34.3% on POD 7. T cell proliferation on POD1 decreased to 29 +/- 26%. APC antigen-presentation on POD 1 also decreased to 31 +/- 36%.


CONCLUSIONS
Open-heart surgery impaired both T cell proliferation and the antigen-presentation. Such synergistic impairment severely impaired adaptive immunity. This impairment was both severer and longer than we anticipated based on previous studies using the response of T cells to lectin as a marker of cell-mediated immunity.
Sano
Tetsuro
T
Division of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Morita
Shigeki
S
Tominaga
Ryuji
R
Masuda
Munetaka
M
Tomita
Yukihiro
Y
Yasutsune
Toru
T
Yasui
Hisataka
H
D000368:Aged; D017951:Antigen Presentation; D000942:Antigens, Bacterial / Q000276:immunology; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D037102:Lectins / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*; D014373:Tuberculin / Q000276:immunology
D000942:Antigens, Bacterial; D037102:Lectins; D014373:Tuberculin