title: Alcohol use disorder and perioperative immune dysfunction.
abstract: The anesthesiological sequelae of long-term alcohol abuse include a three to fivefold increased risk of postoperative infection, prolonged intensive care unit stays and longer hospital stays. The cause of the higher infection rates is an altered immune response in long-term alcoholic patients. Preoperatively, the T helper cells 1 to T helper cells 2 ratio is depressed in long-term alcoholic patients and remains suppressed after surgery. The lower preoperative T helper cells 1 to T helper cells 2 ratio is predictive of later onset of infections. Postoperatively, the cytotoxic lymphocyte (Tc1/Tc2) ratio is decreased in long-term alcoholic patients and remains depressed for 5 days. The interleukin (IL)-6/IL-10 ratio and the lipopolysaccharide-stimulated interferon gamma/IL-10 ratio in whole blood cells are decreased after surgery in long-term alcoholic patients. Depressed Tc1/Tc2, IL-6/IL-10 and lipopolysaccharide-stimulated interferon gamma/IL-10 ratios in the postoperative period are predictive of subsequent postoperative infections. Perioperative interventions should aim to minimize dysregulation of the immune system.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine Unit, Campus Virchow-Klinikum, Charité-University Hospital Berlin, Berlin, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lau
authors.forename: Vera
authors.initials: V
authors.lastname: von Dossow
authors.forename: Michael
authors.initials: M
authors.lastname: Sander
authors.forename: Martin
authors.initials: M
authors.lastname: MacGuill
authors.forename: Nadine
authors.initials: N
authors.lastname: Lanzke
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D000437:Alcoholism / Q000150:complications*; D006801:Humans; D007154:Immune System Diseases / Q000150:complications*; D007111:Immunity, Cellular / Q000187:drug effects / Q000502:physiology; D007378:Interleukins / Q000378:metabolism; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000276:immunology*; D018655:Lymphocyte Count; D019990:Perioperative Care; D011182:Postoperative Care
chemical_list: D007378:Interleukins