title: Influence of vaccination and surgery on HLA-DR expression in patients with upper aerodigestive tract cancer.
abstract: Major surgery is associated with an increased risk of post-operative immunosuppression and infections. We investigated the influence of influenza vaccination on cell-mediated immune responses in cancer patients undergoing either surgical or conservative therapy. Forty patients with an upper aerodigestive tract tumour were allocated to either a surgical or non-surgical treatment course. Patients within each group were randomized to the vaccination or non-vaccination group. Vaccination was performed twice before surgery or conservative treatment. Human leucocyte antigen receptor (HLA-DR) expression on monocytes was analysed by flow cytometry. In the surgical patients, HLA-DR expression on day 1 after surgery decreased in both the vaccinated and non-vaccinated groups. Vaccinated non-surgical patients showed significantly increased HLA-DR expression levels compared with the non-vaccinated patients. This pilot study demonstrated that vaccination increased monocyte HLA-DR expression in conservatively-treated cancer patients whereas surgery abrogated this response. Vaccination before surgery, therefore, might not help to maintain immune reactivity after surgery.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum, Charité-University Medicine Berlin, Germany. claudia.spies@charite.de
authors.forename: C D
authors.initials: CD
authors.lastname: Spies
authors.forename: M
authors.initials: M
authors.lastname: Kip
authors.forename: A
authors.initials: A
authors.lastname: Lau
authors.forename: M
authors.initials: M
authors.lastname: Sander
authors.forename: J P
authors.initials: JP
authors.lastname: Breuer
authors.forename: J
authors.initials: J
authors.lastname: Meyerhoefer
authors.forename: C
authors.initials: C
authors.lastname: Paschen
authors.forename: G
authors.initials: G
authors.lastname: Schumacher
authors.forename: H D
authors.initials: HD
authors.lastname: Volk
authors.forename: K D
authors.initials: KD
authors.lastname: Wernecke
authors.forename: V
authors.initials: V
authors.lastname: von Dossow
mesh_terms: D000368:Aged; D005260:Female; D006684:HLA-DR Antigens / Q000096:biosynthesis* / Q000235:genetics* / Q000502:physiology; D006258:Head and Neck Neoplasms / Q000276:immunology* / Q000601:surgery*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011300:Preoperative Care; D011446:Prospective Studies; D015854:Up-Regulation / Q000276:immunology
chemical_list: D006684:HLA-DR Antigens; D007252:Influenza Vaccines