title: The effects of neurosurgical stress on peripheral lymphocyte subpopulations.
abstract: OBJECTIVE
  To observe changes in the peripheral lymphocyte subpopulations as an index of cellular immunity during neurosurgical procedures.
  
  
  METHODS
  Clinical study.
  
  
  METHODS
  Operating room of a university hospital.
  
  
  METHODS
  11 patients with early intracranial disease who were scheduled to undergo elective neurosurgery with general anesthesia. Patients in the control group (n = 10) underwent minor surgeries such as ophthalmologic, otorhinolaryngological, or orthopedic surgeries.
  
  
  METHODS
  Blood was sampled before anesthesia induction (t0) for baseline and at 1 hour (t(1)) and 2 hours (t(2)) following surgical incision.
  
  
  METHODS
  Detection and quantification of lymphocyte subpopulations were performed at each time point using single-label and double-label analyses of monoclonal antibodies against lymphocyte membrane surface markers.
  
  
  RESULTS
  Significant changes in patients who underwent a neurosurgical procedure included: the percentage of total T cells (CD3+) from 57.54 +/- 3.50% at t(0) to 51.41 +/- 4.26% at t(1) and 46.29 +/- 4.02% at t(2); the percentage of inducer T cells (CD4+, Leu8+) from 27.39 +/- 2.26% at t(0), to 23.26 +/- 2.30% at t(1) and 20.82 +/- 2.70% at t(2); the CD4/CD8 ratio, from 1.78 +/- 0.25% at t(0) to 1.35 +/- 0.12% at t(1) and 1.22 +/- 0.17% at t(2). The percentage of suppressor T cells (CD8+, Leu15+) increased significantly from 10.8 +/- 1.07% at t(0) to 13.64 +/- 1.62% at t(1), and 14.82 +/- 1.24% at t(2). The percentages of the natural killer cell subsets also increased significantly. Control group patients who underwent minor surgeries showed no significant changes.
  
  
  CONCLUSIONS
  Neurosurgery-induced significant suppression of cellular immunity was demonstrated in peripheral lymphocyte subpopulations, probably from the surgical stress on the central nervous system.
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hori
authors.forename: Takae
authors.initials: T
authors.lastname: Ibuki
authors.forename: Toyoshi
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000768:Anesthesia, General; D000911:Antibodies, Monoclonal; D017252:CD3 Complex / Q000187:drug effects; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007694:Killer Cells, Natural; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011956:Receptors, Cell Surface / Q000187:drug effects; D013312:Stress, Physiological / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory
chemical_list: D000911:Antibodies, Monoclonal; D017252:CD3 Complex; D011956:Receptors, Cell Surface