title: PERIOPERATIVE PROGRAMMED DEATH 1 EXPRESSION ON CD4+ T CELLS PREDICTS THE INCIDENCE OF POSTOPERATIVE INFECTIOUS COMPLICATIONS.
abstract: BACKGROUND
  Programmed death 1 (PD-1) has been reported to be an immunoinhibitory receptor expressed by chronically stimulated T cells after T-cell activation. The present study was designed to evaluate the relationship between perioperative PD-1 expression on CD4 T cells and the incidence of postoperative infectious complications in patients undergoing gastroenterological surgery.
  
  
  METHODS
  One hundred one patients with gastroenterological disease were enrolled in this study. Blood samples were taken on the preoperative day (Pre) and the first postoperative day (POD1). We calculated the CD4 T-cell count and the PD-1 expression on CD4 T cells via flow cytometry.
  
  
  RESULTS
  Postoperative infectious complications occurred in 30 of the 101 patients. The CD4 T-cell count was significantly lower in the patients who developed postoperative infectious complications at POD1 compared with the patients who did not. In addition, the PD-1 expression on CD4 T cells was significantly higher at Pre or POD1 in the patients who developed postoperative infectious complications. The preoperative PD-1 expression on CD4 T cells was found to be independently associated with postoperative infectious complications according to multivariate analysis.
  
  
  CONCLUSIONS
  The perioperative CD4 T-cell count or PD-1 expression on CD4 T cells may be early predictive markers for the development of postoperative infectious complications.
authors.affiliation: *Department of Surgery, National Defense Medical College, Saitama †Division of Critical Care Medicine, Hachioji Medical Center, Tokyo Medical University ‡Division of Traumatology, National Defense Medical College Research Institute, Saitama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Hiromi
authors.initials: H
authors.lastname: Miyazaki
authors.forename: Daizoh
authors.initials: D
authors.lastname: Saitoh
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000276:immunology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis* / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D061026:Programmed Cell Death 1 Receptor / Q000097:blood*; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor