Immunological stress in kidney cancer patients undergoing either open nephrectomy or nephron-sparing surgery: an immunophenotypic study of lymphocyte subpopulations and circulating dendritic cells.
Immunosuppression is a characteristic hallmark of renal cell carcinoma (RCC), with several complex immune defects, almost solely at the level of cell-mediated immune function, well evident even in patients at first diagnosis. The main circulating lymphocyte subsets and the total number of circulating dendritic cells were quantified in 47 RCC patients at diagnosis (T0), 12 h (T1), 24 h (T2) and 8 days following either radical nephrectomy or nephron-sparing surgery using flow cytometry. RCC patients presented, at baseline, (T0) a profound state of immunosuppression involving naïve T-cells, memory T-cells, CD16+ NK and total circulating dendritic cells, that worsened after 12 (T1) and 24 h (T2) from surgery, involving the majority of the analysed subsets; after 8 days (T3) from surgical removal of tumor, however, there was a return of all the analyzed parameters to the basal state. In conclusion, surgery causes transient but relevant immune suppression in RCC patients; even though, by day +8, this tends to return to baseline, immunostimulatory therapies could be considered in the peri-operative setting with the aim of reducing immunosuppression and, hopefully, also disease recurrence.
Porta
Camillo
C
Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, I-27100 Pavia, Italy. c.porta@smatteo.pv.it
Bonomi
Lucia
L
Lillaz
Beatrice
B
Klersy
Catherine
C
Imarisio
Ilaria
I
Paglino
Chiara
C
Rovati
Bianca
B
Danova
Marco
M
Ferraris
Elisa
E
Mensi
Mario
M
Rovereto
Bruno
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000276:immunology* / Q000378:metabolism; D003713:Dendritic Cells / Q000378:metabolism*; D005260:Female; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007680:Kidney Neoplasms / Q000276:immunology* / Q000601:surgery* / Q000628:therapy; D016131:Lymphocyte Subsets / Q000378:metabolism; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009399:Nephrons / Q000378:metabolism
D007166:Immunosuppressive Agents