Preoperative GATA3 mRNA expression in peripheral blood mononuclear cells is up-regulated in patients with postoperative infection following hepatobiliary pancreatic surgery.
BACKGROUND
Aggressive hepatobiliary pancreatic surgery has been associated with high complication rates. Correlations of Th1/Th2 balance and toll-like receptor (TLR) 2/4 expression with postoperative infection following surgery were prospectively evaluated.


METHODS
Plasma concentrations of interleukin (IL)-6, IL-10, soluble lymphocyte activation gene (sLAG)-3, and soluble CD30 were determined by enzyme-linked immunosorbent assay, and expression levels of T-bet, GATA-3, TLR2, and TLR4 mRNA in peripheral blood mononuclear cells were assayed by reverse transcription-polymerase chain reaction perioperatively in 56 consecutive patients who underwent hepatobiliary pancreatic surgery.


RESULTS
Of the 56 patients, 30 patients had postoperative infection. Postoperative plasma levels of IL-6 and IL-10 were significantly higher in patients with postoperative infection than in those without infection (P < 0.05). Plasma soluble CD30 level and GATA-3 mRNA expression level were significantly higher preoperatively, and remained higher by postoperative d 7 in patients with postoperative infection (P < 0.05). Soluble lymphocyte activation gene levels were not significantly different between the two groups. T-bet mRNA expression level was significantly higher on postoperative d 3, 7, and 14 in patients with postoperative infection (P < 0.05). Preoperative expression levels of GATA-3 mRNA correlated significantly with those of TLR2 and TLR4 mRNA (P < 0.05).


CONCLUSIONS
These results suggest that in patients with postoperative infection, Th1/Th2 balance shifts toward Th2 dominance preoperatively.
Kawamoto
Jun
J
Department of General Surgery, Chiba University Graduate School of Medicine, Chuo-ku, Chiba, Japan.
Kimura
Fumio
F
Yoshitomi
Hideyuki
H
Shimizu
Hiroaki
H
Yoshidome
Hiroyuki
H
Ohtsuka
Masayuki
M
Kato
Atsushi
A
Nozawa
Satoshi
S
Furukawa
Katsunori
K
Mitsuhashi
Noboru
N
Takeuchi
Dan
D
Miyazaki
Masaru
M
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000097:blood; D004067:Digestive System Neoplasms / Q000601:surgery*; D005260:Female; D050990:GATA3 Transcription Factor / Q000378:metabolism*; D006801:Humans; D007239:Infections / Q000276:immunology / Q000378:metabolism*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D017730:Ki-1 Antigen / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology / Q000378:metabolism*; D012333:RNA, Messenger / Q000378:metabolism; D012307:Risk Factors; D020825:T-Box Domain Proteins / Q000378:metabolism*; D018418:Th2 Cells / Q000378:metabolism; D051195:Toll-Like Receptor 2 / Q000378:metabolism; D051197:Toll-Like Receptor 4 / Q000378:metabolism; D015854:Up-Regulation; D000093322:Lymphocyte Activation Gene 3 Protein; D000098815:T-bet Transcription Factor
D015703:Antigens, CD; D050990:GATA3 Transcription Factor; C494749:GATA3 protein, human; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D017730:Ki-1 Antigen; D012333:RNA, Messenger; D020825:T-Box Domain Proteins; D000098815:T-bet Transcription Factor; C495342:TLR2 protein, human; C495345:TLR4 protein, human; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4; D016753:Interleukin-10; D000093322:Lymphocyte Activation Gene 3 Protein; C000720326:Lag3 protein, human; C000720328:soluble LAG-3 protein, human