The effects of neurosurgical stress on peripheral lymphocyte subpopulations.
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.
Hori
Yoshiyuki
Y
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan.
Ibuki
Takae
T
Hosokawa
Toyoshi
T
Tanaka
Yoshifumi
Y
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
D000911:Antibodies, Monoclonal; D017252:CD3 Complex; D011956:Receptors, Cell Surface