Treatments for the activating macrophages that reduces surgical stress and postoperative mortalities from bacterial infections and tumor metastases.
BACKGROUND
Some of the mortalities caused by infectious diseases and/or distant metastases following surgery are thought to be due to immunological suppression. For this reason, techniques that reduce immunological suppression following surgery may reduce mortalities and/or incidences of micrometastases in distant organs.


METHODS
Mice were anesthetized and their peritoneal cavities were opened for 30 min. Immunological suppression was estimated by the presence of tumor necrosis factor-a (TNF) after injection with OK-432 (dead bacterial bodies). The mice were administered with either Staphylococcus aureus or cancer cells of Meth A fibrosarcoma. Survival times and lung metastastic foci were then observed at 3 weeks. Results were compared for mice with or without treatment by OK432 or TNF prior to surgery.


RESULTS
While significant suppression of TNF production was observed after laparotomy, administration of a macrophage-activating agent (TNF or OK-432) 3 h prior to laparotomy prevented immune suppression after the laparotomy. Laparotomy increased mortalities from bacterial infections and promoted the number of lung metastases. By contrast, administration of TNF or OK-432 3 h prior to the laparotomy decreased mortalities and metastases after the laparotomy.


CONCLUSIONS
These results suggest that appropriate activation of macrophages prior to surgery is a method to reduce some of the detrimental effects caused by surgical operations.
Nakamoto
Takeru
T
Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Enya-cho, Izumo, Shimane, 693-8501.
Yoshimura
Hiroshi
H
Honda
Teruko
T
Nakata
Kazue
K
Taniguchi
Yoshie
Y
Yoshida
Aya
A
Uenobe
Maya
M
Yoshioka
Noriko
N
Yamaguchi
Takatoshi
T
Inagawa
Hiroyuki
H
Kohchi
Chie
C
Nishizawa
Takashi
T
Soma
Gen-Ichiro
G
D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000517:prevention & control*; D003643:Death; D005354:Fibrosarcoma / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008262:Macrophage Activation; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D009362:Neoplasm Metastasis / Q000517:prevention & control; D010844:Picibanil / Q000627:therapeutic use; D012513:Sarcoma, Experimental / Q000276:immunology / Q000473:pathology / Q000601:surgery; D013203:Staphylococcal Infections / Q000517:prevention & control; D013211:Staphylococcus aureus; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000970:Antineoplastic Agents; D014409:Tumor Necrosis Factor-alpha; D010844:Picibanil