title: Surgery decreases number of cells secreting cytotoxic mediators and increases secretion of interleukin 10 in patients with lung cancer.
abstract: OBJECTIVE
  The phenomenon of immunosuppression induced by surgery is widely described as the adverse impact of surgical interventions on leukocytes' populations and secretion of several cytokines. Best of our knowledge, we present the first report evaluating the effect of surgical treatment on the specific anti-cancer immune response against tumour antigens.
  
  
  METHODS
  The study included 30 patients operated on for lung cancer. Specific secretion of IFN-γ, Granzyme B, perforines, IL-4, IL-5, IL-10, IL-17a was assessed by ELISPOT (Enzyme-Linked Immunosorbent Spot Assay).
  
  
  RESULTS
  Number of cells secreting IFN-γ, Granzyme B and perforines under the influence of autologous tumour antigens or mitogens was significantly decreased on the first day after surgery. During the postoperative recovery we observed an increase in the number of cells secreting IFN-γ, but on the 7th day it still remained lower than before the operation. On the 28th postoperative day it reached a level which was not significantly higher than before the surgery. On the 1st and 7th postoperative day we discovered a significant increase in IL-10 secretion, in response to autologous tumour antigens.
  
  
  CONCLUSIONS
  Our results suggest an immunosuppressive effect of surgery on the specific and nonspecific immune stimulation. This effect is particularly expressed in relation to Th1-type immunological response which is associated with direct elimination of cancer cells. Another unfavourable observation is elevated secretion of immunosuppressive IL-10 in response to cancer antigens. These phenomena are associated with shorter survival of the patients.
authors.affiliation: Chair and Department of Thoracic Surgery, Medical University of Lublin, SPSK 4, Jaczewskiego 8, 20-090 Lublin, Poland. Electronic address: rybojad@wp.pl.
authors.forename: P
authors.initials: P
authors.lastname: Rybojad
authors.forename: A
authors.initials: A
authors.lastname: Jabłonka
authors.forename: B
authors.initials: B
authors.lastname: Wilczyńska
authors.forename: J
authors.initials: J
authors.lastname: Tabarkiewicz
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D018287:Carcinoma, Large Cell / Q000276:immunology / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000276:immunology* / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000601:surgery; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D053804:Granzymes / Q000378:metabolism*; D006801:Humans; D007108:Immune Tolerance; D007371:Interferon-gamma / Q000378:metabolism*; D016753:Interleukin-10 / Q000378:metabolism*; D007378:Interleukins / Q000378:metabolism; D008175:Lung Neoplasms / Q000276:immunology* / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D054353:Perforin / Q000378:metabolism*; D011184:Postoperative Period; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects*
chemical_list: D007378:Interleukins; D054353:Perforin; D016753:Interleukin-10; D007371:Interferon-gamma; D053804:Granzymes
keywords: ELISPOT; Immunosuppression; Lung cancer; Specific immunologic response