title: Changes in the response of neutrophils to endotoxin priming following major abdominal surgery.
abstract: Endotoxin (ETX) primes polymorphonuclear cells (PMNs) for the subsequent release of reactive oxygen species (ROS) in response to various stimulants such as phorbol myristate acetate (PMA). Although PMNs contribute to oxidative stress after stimulation by standard stimulants and after priming by many humoral factors, it is unknown whether the PMNs from patients at different postoperative times exhibit the same response to the same standard stimulant. We examined the response of PMA-induced production of ROS from PMNs at various intervals after major abdominal surgery in response to ETX priming. This study was a prospective clinical and laboratory study conducted over a 7-day period that involved 25 patients who were referred for elective major abdominal surgery (8 for gastric cancer, 9 for colonic cancer, 8 for rectal cancer). Blood was sampled on the day before operation and on postoperative days (PODs) 1, 3, and 7. For each sample we measured luminol-dependent chemiluminescence (CL), the time to peak counts (Tmax) of PMNs stimulated by PMA, and the serum ETX level. We studied the correlation between CL and ETX in samples from PODs 1 and 3. We also studied the CL of PMNs on PODs 1 and 3 preincubated (primed) with various concentrations of ETX (0, 20, 40, 60, and 100 pg/ml). We found that CL decreased on POD 1 compared with the preoperative level (p <0.05) because of the decreased Tmax. The level of CL per 1 ml of whole blood, however, was higher on PODs 1 and 3 than preoperatively. During this time, leukocytosis should compensate for the impaired production of ROS by an individual PMN. The serum ETX level was increased on POD 1 (p <0.05). There was a negative correlation between CL and ETX on POD 1 (correlation coefficient ?0.62, p < 0.01) and a positive correlation on POD 3 (0.61, p <0.01). CL on POD 3 was accelerated by ETX priming, but the CL on POD 1 was depressed by the priming using a low concentration of ETX. The mode of the response of PMNs to ETX priming differed between PODs 1 and 3. On POD 1 the responses of PMNs to environmental stimulants is suppressed, but by POD 3 these responses had increased.
authors.affiliation: Department of Critical Care and Emergency Medicine, Yokohama City University, School of Medicine, 4-57 Urafune-cho, Minami-ku, Yokohama, Japan. qqc3@urahp.yokohama-cu.ac.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Moriwaki
authors.forename: Mitsugi
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Ozawa
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kamiya
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Suda
mesh_terms: D013505:Digestive System Surgical Procedures; D004731:Endotoxins / Q000494:pharmacology*; D006801:Humans; D008163:Luminescent Measurements; D009504:Neutrophils / Q000187:drug effects* / Q000378:metabolism; D011184:Postoperative Period; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism*; D013755:Tetradecanoylphorbol Acetate / Q000494:pharmacology
chemical_list: D004731:Endotoxins; D017382:Reactive Oxygen Species; D013755:Tetradecanoylphorbol Acetate