title: Major surgical trauma differentially affects T-cells and APC.
abstract: Macrophages have been reported to initiate immunosuppression following trauma and hemorrhage, and recent experimental studies suggest a pivotal role of T-cells in maintaining immunosuppression. The aim of the present study was to investigate the interaction of APC and T-cells in humans following major surgery. First, APC and T-cells from 14 surgical patients were isolated, counted and characterized by their specific surface marker profile 2 and 24 h postoperatively. Then, these cells were co-incubated with cells of the other type, which had been isolated pre-operatively. Chemokine secretion from pre-operative cells as measured by enzyme immunoassay served as a bioassay for the function of the stimulating postoperative cells. CD3(+) T-cells and surface marker CD28 were markedly suppressed postoperatively, while CD3(+)CD25(+)CD127(-)Tregs were not suppressed. CD14(+)APC counts were increased with the most significant increase observed in CD14(+)HLA-DR(-) myeloid-derived suppressor cells. In co-cultures, APC showed increased postoperative secretion of TNF-α and IL-6 independently of whether they had been co-incubated with pre- or postoperative T-cells. T-cells incubated with CD14(+) cells 2 h postoperatively secreted diminished amounts of IFN-γ. The results of the study suggest that T-cells play a pivotal role in mediating immunosuppression after major abdominal surgery.
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Großhadern, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Albertsmeier
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Großhadern, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Quaiser
authors.affiliation: Department of Anaesthesiology, Klinikum Großhadern, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: von Dossow-Hanfstingl
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Großhadern, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Hauke
authors.initials: H
authors.lastname: Winter
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Großhadern, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Eugen
authors.initials: E
authors.lastname: Faist
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Großhadern, Ludwig-Maximilian University, Munich, Germany martin.angele@med.uni-muenchen.de.
authors.forename: Martin K
authors.initials: MK
authors.lastname: Angele
mesh_terms: D000368:Aged; D000938:Antigen-Presenting Cells / Q000276:immunology*; D000954:Antigens, Surface / Q000276:immunology; D018925:Chemokines / Q000378:metabolism; D018920:Coculture Techniques; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D008264:Macrophages / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology*; D011184:Postoperative Period; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D014947:Wounds and Injuries / Q000276:immunology*
chemical_list: D000954:Antigens, Surface; D018925:Chemokines
keywords: Ag-presenting cells; T-cells; Trauma; cellular immune response; hemorrhage; monocytes