title: Major hepatectomy induces phenotypic changes in circulating dendritic cells and monocytes.
abstract: BACKGROUND
  Patients undergoing major hepatectomy are at increased risk for post-operative morbidity and mortality, and changes in the phenotype of effector cells may predispose these patients to infectious sequelae.
  
  
  METHODS
  To better understand post-hepatectomy immune responses, peripheral blood from 15 hepatectomy patients was drawn immediately before and after liver resection and on post-operative days 1, 3, and 5. Circulating monocytes and dendritic cells were analyzed by flow cytometry for quantity, phenotype, activation status, human leukocyte antigen DR (HLA-DR) expression, and toll-like receptor-2 and -4 expression.
  
  
  RESULTS
  Major hepatectomy increased the numbers of activated CD16(bright) blood monocytes and the percentage of activated dendritic cells, although monocyte HLA-DR expression was reduced. These results may represent both dysfunctional antigen presentation and pending anergy, as well as cellular priming of immune effector cells. Better understanding of the alterations in innate immunity induced by hepatectomy may identify strategies to reduce infectious outcomes.
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Shands Hospital, Box 100286, Gainesville, FL 32610-0286, USA. Philip.Efron@surgery.ufl.edu
authors.forename: Philip A
authors.initials: PA
authors.lastname: Efron
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Priscilla F
authors.initials: PF
authors.lastname: McAuliffe
authors.forename: Philip
authors.initials: P
authors.lastname: Scumpia
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ungaro
authors.forename: Shiro
authors.initials: S
authors.lastname: Fujita
authors.forename: Lyle L
authors.initials: LL
authors.lastname: Moldawer
authors.forename: David
authors.initials: D
authors.lastname: Foley
authors.forename: Alan W
authors.initials: AW
authors.lastname: Hemming
mesh_terms: D000368:Aged; D017951:Antigen Presentation; D049109:Cell Proliferation; D002478:Cells, Cultured; D003713:Dendritic Cells / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006684:HLA-DR Antigens / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D006498:Hepatectomy; D006801:Humans; D016130:Immunophenotyping; D007239:Infections / Q000097:blood / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D008262:Macrophage Activation; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D011183:Postoperative Complications / Q000276:immunology*; D011446:Prospective Studies; D017452:Receptors, IgG / Q000096:biosynthesis; D051195:Toll-Like Receptor 2 / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D051197:Toll-Like Receptor 4 / Q000235:genetics / Q000276:immunology / Q000378:metabolism
chemical_list: D006684:HLA-DR Antigens; D017452:Receptors, IgG; C495342:TLR2 protein, human; C495345:TLR4 protein, human; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4