[Surgical trauma and postoperative immunosuppression].
Abdominal surgery is regularly followed by immune dysfunction that can last for several days. In case of septic complications during this period, there is imminent danger of mortality due to reduced immune function. This fact leads to classification of sepsis in regard to its genesis: spontaneously acquired sepsis type A is distinguishable from sepsis type B, which is acquired postoperatively. The main difference between these types is the immunologic condition at the time point of sepsis development. Postoperative immune dysfunction can be described by several parameters, i.e. reduction of HLA-DR expression on monocytes and increased apoptosis of T lymphocytes. A direct correlation exists between magnitude of immune dysfunction and complexity of the previous surgical trauma. For the first time it is now possible to study this phenomenon of postoperative immune dysfunction by use of an adequate animal model. Intestinal manipulation in mice fulfils the necessary criteria to serve as a model of surgically induced immune dysfunction.
Koerner
P
P
Klinik und Poliklinik für Chirurgie, Abteilung für Allgemein-, Viszeral-, Thorax- und Gefässchirurgie, Universitätsklinikum Greifswald, Greifswald, Germany.
Westerholt
A
A
Kessler
W
W
Traeger
T
T
Maier
S
S
Heidecke
C-D
CD
D000818:Animals; D017209:Apoptosis / Q000276:immunology; D004195:Disease Models, Animal; D006684:HLA-DR Antigens / Q000097:blood; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007153:Immunologic Deficiency Syndromes / Q000175:diagnosis / Q000276:immunology*; D007410:Intestinal Diseases / Q000276:immunology / Q000601:surgery; D009000:Monocytes / Q000276:immunology; D011183:Postoperative Complications / Q000175:diagnosis / Q000276:immunology*; D018805:Sepsis / Q000175:diagnosis / Q000276:immunology; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology
D006684:HLA-DR Antigens