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PubMed1985

Immune function in blood donors following short-term lymphocytapheresis.

Lymphocyte losses occur during repeat plateletpheresis and/or leukapheresis procedures and are potentially harmful to normal host immune function. This concern prompted us to study the effect of repeat lymphocytapheresis (lymphapheresis) on the immune system of healthy blood donors. Following a total of six lymphapheresis procedures over a 12-day period with removal of a mean of 41.6 X 10(9) lymphocytes, there were no significant changes in donor (n = 5) absolute lymphocyte counts, quantitative immunoglobulin levels or immune response capability as assessed by the following in vitro assays: percent of E, EA, and EAC rosette-forming cells, the percent of surface membrane immunoglobulin bearing cells, and the blastogenic responses to stimulation with phytohemagglutinin, pokeweed mitogen and concanavalin A. The procedures were well-tolerated without complications. During a follow-up period of 18 months, significant increases in total white cell counts (but not absolute lymphocyte counts), and in quantitative immunoglobulin levels (IgG, IgM, and IgA) were observed. The median increases in immunoglobulin levels ranged from 27.5% for IgG to 44% for IgA. We conclude that lymphapheresis as described is relatively safe and our results are reassuring in relation to lymphocyte losses that may occur during repeat cytapheresis procedures of normal blood donors.

Blood Donors↗

PubMed1991

Immunologic biomarkers associated with an acute exposure to exothermic byproducts of a ureaformaldehyde spill.

A community was exposed for several days to formaldehyde (HCHO), hexamethylenetetramine, trimethylamine, and paraformaldehyde emitted from an overheated tanker car containing ureaformaldehyde resin. Residents experienced acute HCHO symptoms at the time of the accident. Many developed chronic, multiple organ health complaints. Three years following the accident, exposed subjects were compared to residents of a nearby unexposed community for the following immunological parameters: white blood cell count, total lymphocyte count, percent and total lymphocyte subsets (CD5, CD4, CD8, CD19, CD25, and CD26 cells), prevalence of autoantibodies, and antibodies to HCHO-human serum albumin (HCHO-HSA) conjugate. The data were adjusted for gender, age, history of smoking, mobile home residency, and use of wood stoves. There was a statistically significant difference for the following: elevated percent and absolute numbers of CD26 cells (p less than 0.0001); autoantibodies (p less than 0.004), and greater titers of isotypes IgG (p less than 0.0005) and IgM (p less than 0.005) to HCHO-HSA. It is concluded that the exposed subjects had an activated immune system in addition to the elevated autoantibodies. Also, isotypes to HCHO-HSA resulted from the exposure and no other sources, such as smoking, mobile home residency, and use of wood stoves.

Adolescent↗

PubMed1998

The incidence of AIDS-defining illnesses in 4883 patients with human immunodeficiency virus infection. Royal Free/Chelsea and Westminster Hospitals Collaborative Group.

BACKGROUND: Acquired immunodeficiency syndrome (AIDS)-defining illnesses are known to occur at different levels of immunosuppression, and the incidence of diagnoses may also vary according to the CD4 lymphocyte count strata. Information about the incidence of disease at different levels of immunosuppression would help clinicians monitoring patients and would allow prophylaxis to be targeted at the most appropriate population. METHODS: Between 1982 and July 1995, 4883 patients testing positive for the human immunodeficiency virus were seen at either the Royal Free or Chelsea and Westminster Hospitals in London, England. The incidence of each diagnosis, both overall and stratified by CD4 lymphocyte count, was calculated using a person-years analysis. Patients who had no CD4 lymphocyte counts measured during follow-up were excluded from the analysis. RESULTS: During a median follow-up period of 27.6 months, 3875 AIDS-defining illnesses were reported in 1713 patients. The incidence of AIDS-defining illnesses ranged from 6.22 per 100 person-years of follow-up for Pneumocystis carinii pneumonia (95% confidence interval, 5.74-6.70) to 0.37 for extrapulmonary tuberculosis (95% confidence interval, 0.26-0.48). The incidence of each AIDS-defining illness increased as the CD4 lymphocyte count declined; diagnoses such as cytomegalovirus and Mycobacterium avium-intracellulare complex infection had a low incidence at CD4 lymphocyte counts above 0.05x10(9)/L (50/mm3), while Kaposi sarcoma, P carinii pneumonia, and esophageal candidiasis had a high incidence throughout all CD4 lymphocyte count strata. CONCLUSIONS: This study provides important information about the risk of AIDS-defining illnesses at lower CD4 lymphocyte counts, enabling disease-specific prophylaxis to be targeted at the most appropriate population. In the future, as more prophylactic therapies are developed, this study will provide historical data of the incidence of diseases before specific prophylaxis was introduced.

AIDS-Related Opportunistic Infections↗

PubMed1999

Lymphocyte subpopulations in intrauterine growth retardation in women with or without previous pregnancies.

OBJECTIVE: To evaluate lymphocyte subpopulations in pregnant women with intrauterine growth retardation (IUGR). STUDY DESIGN: Forty-two normotensive and healthy women with singleton pregnancies and intrauterine growth retardation were studied in the third trimester of pregnancy and compared with 42 normal pregnant women. Peripheral blood lymphocytes were studied using murine monoclonal antibodies and flow cytometry. RESULTS: B-lymphocytes in both total number (312.54 vs. 163.19 cells/mm3; P = 0.000003) and percentage (11.04% vs. 7.07%; P = 0.000002) were significantly increased in patients with IUGR in comparison to normal pregnant women. Significant correlations were found between birthweight and both total number and percentage of lymphocytes B. In primigravid women, we found that women with IUGR had a higher total lymphocyte count (2749.09 vs. 2130 cells/mm3; P = 0.006), higher T-lymphocyte count (2053.77 vs. 1676.40 cells/mm3; P = 0.02), higher B-lymphocyte count and percentage (309.13 vs. 145.36 cells/mm3; P = 0.000001) (11.45 vs. 6.81%); P = 0.00001), higher CD4 lymphocyte count and percentage (1342.68 vs. 972.22 cells/mm3, P = 0.001) (49.18 vs. 44.04%; P = 0.04), lower CD8-lymphocytes percentage (28.27 vs. 32.9%; P = 0.04), and higher CD4/CD ratio (1.83 vs. 1.46; P = 0.02) than the normal control group. CONCLUSIONS: B-lymphocytes are increased in women with IUGR in comparison to women with normal pregnancies and there was a significant negative correlation between maternal B-lymphocytes and birthweight. With respect to T-lymphocytes, the immunological profile is different according to the presence or absence of a previous pregnancy. Fetal immunological rejection could be involved in the pathogenesis of IUGR in primigravid women, but in multigravid women there were no differences between women with IUGR and those with normal fetal growth.

Adult↗

PubMed1981

Immune status of the neonate maintained on total parenteral nutrition.

Immunological studies were carried out on 7 neonates maintained on total parenteral nutrition for periods ranging from 14 to 31 days after surgery for correction of gastrointestinal anomalies. IgM and IgA levels were high in all patients but IgG levels were low, compared with normal values. Total leucocyte counts, absolute lymphocyte counts, and T- and B-lymphocytes in all patients were similar to those of healthy controls. Neonates maintained on adequate total parenteral nutrition showed no evidence of impairment of immune function.

B-Lymphocytes↗

PubMed1986

Long-term (5-11 years) follow-up of general immune competence in breast cancer. I. Pre-treatment levels with reference to micrometastasis.

General immune competence was measured before treatment in 185 breast cancer patients. They were then followed for 5 to 11 years to determine its relationship to recurrence and its clinical value in predicting prognosis. The tests of immune competence used were immunoglobulins IgG, IgA, IgM, leucocyte counts, percentage and total lymphocyte counts and Mantoux and DNCB skin hypersensitivity tests. None of these tests was strongly predictive of recurrence on an individual basis, a finding similar to our results at 2 years. The longer period of follow-up now reported has provided no findings of unequivocal statistical significance, but suggests a biphasic host response to early tumours. The patients who developed recurrence within 5-11 years due to micrometastasis had higher lymphocyte counts in their preoperative assessment than patients who remained recurrence free. This suggests that small tumour volumes do not stimulate immunity and that large volumes depress it; tumours in between these groups are associated with higher levels. Examination of studies by a number of authors reveal parallel findings which have not been previously noted. It is not possible to confirm the significance of these findings from this study because of the heterogeneity of human breast cancer. However, if they indicate a general principle of a dynamic host-tumour interplay they have important implications for assessing immune competence at any single point of time and for the theory that cancer may arise during an anergic state. We hope that these findings will stimulate other workers to examine host-tumour interaction from this point of view.

Breast Neoplasms↗

PubMed1992

Risk of developing cytomegalovirus retinitis in persons infected with the human immunodeficiency virus.

This study examines the risk of developing cytomegalovirus (CMV) retinitis as a function of the duration and degree of CD4+ lymphocyte depletion. A retrospective analysis of 135 persons infected with the human immunodeficiency virus (HIV) was performed. Kaplan-Meier estimates for the percentage of patients developing CMV retinitis during the 27-month study period were calculated. Twenty-six patients were diagnosed as having CMV retinitis. In 14 of these patients, T cell phenotyping was done within the 3 months preceding diagnosis. The mean CD4+ lymphocyte count for these patients was 15.6 cells/mm3 (range, 2-33/mm3). At 27 months, the percentage of patients developing CMV retinitis with baseline CD4+ lymphocyte counts of 0-50, 51-100, and 101-250 cells/mm3 was 41.9%, 26.3%, and 14.7%, respectively (log-rank test, p = 0.003). The odds ratio for developing CMV retinitis for those with baseline CD4+ lymphocyte counts of 0-50 cells/mm3 compared with those with CD4+ lymphocyte counts of 101-250 cells/mm3 was 4.62 (p = 0.002). Twenty-four patients had CD4+ lymphocyte counts of < or = 50 cells/mm3 for an average of 13.1 months prior to diagnosis. Twenty-two patients had an acquired immune deficiency syndrome (AIDS)-defining illness diagnosed for an average of 18.0 months prior to the onset of retinitis. CMV retinitis is most likely to develop in patients with AIDS when the CD4+ lymphocyte count is < or = 50 cells/mm3.

Acquired Immunodeficiency Syndrome↗

PubMed1982

Treatment of severe aplastic anemia with antithymocyte globulin.

Eleven patients with acute-onset (less than 2 months), severe aplastic anemia were treated with antithymocyte globulin (ATG) at a total dose between 50 and 420 mg/kg. Median age was 27 (5-74) years. Two additional patients with chronic severe aplastic anemia received ATG but were excluded from analysis after development of bone marrow morphologic and cytogenetic abnormalities suggestive of acute leukemia. Of the 11 analyzed patients, 5 died within 6 months after initial ATG treatment. Six patients, or 54 percent, survived with a minimum follow-up of 24 months and the longest 48 months. Median survival is 42 months. All patients are transfusion-independent although none are completely normal, due to mild thrombocytopenia. The in vitro effect of ATG on pretreatment marrow CFUE was determined in 8 patients and concordance with clinical outcome was observed for only 3 patients. Three patients had no in vitro response and survived, and 2 patients had a positive in vitro response and died. Survival after ATG correlated with maximum percent decrease in absolute lymphocyte count during treatment. No significant correlation was determined for any other parameter. The mechanism of ATG action remains unknown but the clinical response suggests that immune dysfunction may play an important role in the development or prolongation of aplastic anemia, and that this abnormality may be reversible by ATG in some patients.

Acute Disease↗

PubMed1974

The immune competence of patients with inflammatory bowel disease.

Previous investigations of immune function in patients with Crohn's disease have yielded conflicting results. A comprehensive study of immune competence-peripheral lymphocyte count, serum immunoglobulin levels (IgG, IgA and IgM), lymphocyte response to PHA, Mantoux test, and DNCB response-has been performed in a large number of patients with inflammatory bowel disease. A total of 52 patients with Crohn's disease, 20 patients with ulcerative colitis, and 46 control patients with benign gastrointestinal disease were investigated. The patient groups were subdivided into ;well' and ;ill' in view of the differing clinical states of patients with inflammatory bowel disease. Some of the Crohn's and colitis patients were receiving steroid therapy. The peripheral blood lymphocyte count and lymphocyte response to PHA were similar in all patient groups. Serum IgA levels were elevated in Crohn's disease but fell significantly in ;ill' Crohn's patients following excisional surgery. Serum IgM levels rose significantly in ;ill' Crohn's patients after surgery. Steroid therapy was associated with diminution of both Mantoux and DNCB responses in the ;ill' Crohn's patients. There was no evidence of impairment of immune competence in either Crohn's disease or ulcerative colitis.

Adolescent↗

PubMed2004

[Is cellular immunity not impaired after remission induction in acute lymphoblastic leukemia in children].

UNLABELLED: We examined immune system at the time of diagnosis and after remission induction in the group of 30 children (aged 6.5 +/- 3.6) with acute pre-B lymphoblastic leukaemia (ALL). The group was divided into standard risk group (treated with BFM protocol, n = 20) and high risk group (New York protocol, n = 10). We measured: episodes of infection, leukocytosis, immunoglobulin concentrations (G, M, A and E), lymphocytes and their subpopulations (CD19+, CD3+, CD3 + HLA-DR+, CD4+, CD8+, CD4 + CD45RA+, CD4 + CD45RO+, CD8 + CD45RA+, CD8 + CD45RO+, CD16 + CD56+). RESULTS: Immunoglobulin concentrations at the time of diagnosis were normal, and decreased after remission induction only reduction of IgG concentration was statistically significant (p = 0.008). At the time of diagnosis we noted the following differences in examined group compared to control group: higher leukocytosis (p = 0.03), lower lymphocyte count (p = 0.0008), significantly lower lymphocyte subpopulation count (for subpopulations CD19+; CD3+; CD4+; CD8+ and CD16 + 56+). After remission induction comparing to the time of diagnosis we observed: total leukocytosis reduction (p = 0.01), percentage and count CD19+ lymphocytes reduction (adequately p = 0.000007, p = 0.03), increase of lymphocyte CD3+ percentage (p = 0.002) and CD8+ lymphocyte percentage (p = 0.00003). CONCLUSIONS: 1. At the time of diagnosis of acute lymphoblastic leukaemia in children lower counts of all lymphocyte populations are observed. 2. Immune suppression after remission induction in this group of patients concerns mainly humoral response, particularly immunoglobulin G production. 3. Severe infections in patients treated for acute lymphoblastic leukaemia are indication to immunological system assessment and early immunoglobulin supplementations of deficits e.g. immunoglobulin infusions. 4. Humoral immunity impairment in children with ALL is an effect of treatment, not disease.

Adolescent↗

PubMed1981

The in vivo and in vitro effects of levamisole in patients with lepromatous leprosy.

Levamisole, 150 mg daily, was administered on 2 consecutive days per week for 6 weeks to two groups of patients with lepromatous leprosy. Group I was composed of patients who were receiving specific anti-leprosy therapy for varying periods of time and Group II were untreated lepromatous patients. Whereas half the patients in Group I received levamisole and the other half a placebo, those in Group II all received levamisole. Patients in both groups showed a) no clinical improvement, b) no conversion of the lepromin reaction, c) no histological change in skin biopsies, d) conversion of SKSD skin reactions from negative to positive in 20% of patients from each group, and e) unaltered absolute neutrophil counts. Whereas the total lymphocyte counts were unchanged in patients from Group I, 13 patients from Group II showed an increased lymphocyte count of greater than 10%. Lymphocyte transformation and lymphokine production in the second group showed no significant change, although four patients showed some lymphokine production after levamisole therapy. E and EAC rosettes were significantly increased in cases where these were reduced prior to treatment with levamisole-Side effects due to levamisole were not experienced.

Adolescent↗

PubMed1988

Enumeration of T and B lymphocytes in bovine leukemia virus-infected cattle, using monoclonal antibodies.

Monoclonal antibodies and microfluorimetry were used to determine the absolute number of B and T lymphocytes in the blood of bovine leukemia virus (BLV)-infected cows. The blood lymphocyte populations from BLV-infected cows were significantly higher than those from BLV-negative cows. The increase in the lymphocyte population in 3 BLV-infected nonlymphocytotic cows was attributed to a significant increase in the number of T lymphocytes; in 3 BLV-infected persistently lymphocytotic cows, the increase was attributed to a significant increase in the number of B and T lymphocytes. One persistently lymphocytotic cow had a high lymphocyte count, and lymphocytes from this cow contained cells that appeared to stain with markers specific for bovine B and T lymphocytes. We concluded that infection of cattle with the B-cell lymphotropic retrovirus, BLV, not only affected B cells, but also T cells.

Animals↗

PubMedDate not supplied

The chronic effects of Fusarium moniliforme culture material, containing known levels of fumonisin B1, in turkeys.

Fourteen 1-day-old male turkeys were randomly assigned to two adjacent floor pens and fed balanced rations containing 0 and 75 mg fumonisin B1 (FB1)/kg for 18 weeks. Inclusion of FB1 in the ration caused decreased body weight gain on weeks 4, 10, and 12 during the trial. Turkeys fed 75 mg FB1/kg had significantly heavier livers after treatment for 18 weeks. Chronic FB1 exposure resulted in an increased total white blood cell count, absolute heterophil count, absolute lymphocyte count, and heterophil-to-lymphocyte ratio. No mortality was noted in turkeys in either treatment group. Turkeys are relatively resistant to chronic FB1 exposure.

Animals↗

PubMed1983

Ontogeny of con A and PHA responses of chicken blood cells in MHC-compatible lines 6(3) and 7(2).

The development of T cell responsiveness to Con A and PHA was examined in two MHC-compatible inbred chicken lines, RPRL 6(3) and 7(2), at ages 2 to 118 days posthatching. These lines are respectively resistant or susceptible to Marek's disease, a naturally occurring, virally induced T cell lymphoma. Between-line comparisons were made of optimal in vitro responses of diluted serum-free blood cells to each mitogen in two groups of chicks tested over ages 2 to 63 and 41 to 118 days. Over 2 to 63 days, Con A responses increased with age at the same rate in each line, but 7(2) responses averaged 2.3 times higher than 6(3). The increase with age was dependent on blood lymphocyte counts, which also increased with age in parallel in both lines. In contrast, the between-line difference in responsiveness was dependent on intrinsic reactivity of cells as well as lymphocyte counts. Covariance analysis was used to estimate that line 7(2) was 1.4 times higher than 6(3) in intrinsic cell reactivity, after accounting for the effect of the twofold higher blood lymphocyte counts in 7(2), and that this intrinsic difference contributed almost one-half the total difference. Over 41 to 118 days Con A responses no longer increased with age, although lymphocyte counts were still increasing, and the line difference (2.6 times) was now almost entirely contributed by a 2.3-fold superiority of 7(2) blood cells in intrinsic reactivity. The line difference in PHA responses was the reverse of the above in young chicks, with 6(3) responses greater than 7(2) in spite of lower lymphocyte counts. In additional chicks tested over 5 to 26 days, intrinsic reactivity of 6(3) cells to PHA averaged 4.5 times higher than 7(2). There was an abrupt decline in intrinsic reactivity of line 6(3) blood cells between 26 and 41 days to a level equal with 7(2). After this age, line 7(2) responses were 1.8 times greater than those of 6(3), and this difference was dependent solely on lymphocyte count differences. The results suggest that different gene systems mediate blood cell responses to PHA as compared with Con A. The pattern of developmental differences between inbred lines indicates the existence of distinct or partly overlapping T cell subsets with different reactivities to PHA or Con A, and of higher suppressor activity of adherent cells in line 6(3) blood. Both these differences may be related to line 6(3) inherited resistance to Marek's disease.

Aging↗

PubMed2002

Postnatal development of leukocyte subset composition and activity in dogs.

The aim of the presentation is to summarise our data on the counts and activity of circulating canine leukocytes at birth and on their changes in the first 3 months of life. On day 1, neutrophil counts were almost three times higher than lymphocyte counts. During the first week of life, a decrease of neutrophil and an increase of lymphocyte counts, resulting in a predominance of lymphocytes, were observed. Neutrophil counts reached values comparable with those in adults in 1 month. Lymphocyte counts were higher than those in adults during the first 3 months. From birth to the age of 3 months, the phagocytic activity of neutrophils was nonsignificantly higher than in young adults. When compared with adults, the peripheral blood of new-born pups contained a lower proportion of T lymphocytes (detected by CD3 and CD5 markers), with a very low percentage of CD8(+) cells and a higher proportion of CD21(+) B lymphocytes. The counts of individual subsets levelled out during the first 3 months of life, although the proportion of CD21(+) B cells remained higher all the time. Lymphocytes of new-born pups were able to respond to nonspecific mitogen stimulation. Spontaneous proliferation in vitro was higher during the first week of life. Although in vitro stimulation of lymphocytes with Concanavalin A in some pups was comparable with that of adult dogs, mean activity was weaker. Pups with zero or very low levels of maternal antibodies were able to develop specific immune responses to a parvovirus antigen as early as at 2 weeks of age. On the basis of these data, we assume that pups are born with an immune system that can respond to external stimuli. Nevertheless its development continues in the postnatal period and some parameters differ from adult values for at least 3 months after birth.

Animals↗

PubMed1998

Focal mycobacterial lymphadenitis following initiation of protease-inhibitor therapy in patients with advanced HIV-1 disease.

BACKGROUND: Inhibitors of HIV-1 protease produce a rapid decrease in plasma HIV-1 RNA, with concomitant increases in CD4 T-helper lymphocyte counts. The main side-effects of the protease inhibitors currently in use include gastrointestinal disturbances, paraesthesias, hyperbilirubinaemia, and nephrolithiasis. The increasing use of these agents in patients with advanced HIV-1 infection and CD4 counts of less than 50 cells/microL may be associated with unforeseen adverse effects not observed in earlier studies of patients with higher CD4 counts. METHODS: Five HIV-infected patients with baseline CD4 lymphocyte counts of less than 50 cells/mL were admitted to the Beth Israel Deaconess Medical Center (Boston, MA, USA) with high fever (> 39 degrees C), leucocytosis, and evidence of lymph-node enlargement within 1-3 weeks of starting indinavir therapy. Informed consent was obtained for studies that entailed CD4 lymphocyte counts, immunophenotyping, isolator blood cultures, and radiological scans. Biopsy samples of cervical, paratracheal, or mesenteric lymph nodes were taken for culture and pathology in four patients. FINDINGS: Lymph-node biopsy samples showed that focal lymphadenitis after initiation of indinavir resulted from unsuspected local or disseminated Mycobacterium avium complex (MAC) infection. The prominent inflammatory response to previously subclinical MAC infection was associated with leucocytosis in all patients and with an increase in the absolute lymphocyte counts in four patients. Three patients with follow-up CD4 counts showed two-fold to 19-fold increases after 1-3 weeks of indinavir therapy. Immunophenotyping after therapy in two patients showed that more than 90% of the CD4 cells were of the memory phenotype. INTERPRETATION: The initiation of indinavir therapy in patients with CD4 counts of less than 50 cells/mL and subclinical MAC infection may be associated with a severe illness, consisting of fever (> 39 degrees C), leucocytosis, and lymphadenitis (cervical, thoracic, or abdominal). The intense inflammatory reactions that make admission to hospital necessary may be secondary to significant numbers of functionally competent immune cells becoming available to respond to a heavy mycobacterial burden. Prophylaxis or screening for subclinical MAC infection, or both, should therefore be done before the beginning of protease-inhibitor therapy in patients with advanced HIV infection.

AIDS-Related Opportunistic Infections↗

PubMed2006

Immunophenotype characteristics of peripheral blood mononuclear leukocytes of chronic idiopathic urticaria patients.

The pathogenesis of chronic idiopathic urticaria (CIU) is not completely understood although autoimmunity has been proposed. The aim of the study was to assess the expression of different leukocyte antigens, by flow cytometry, assaying total blood of 29 patients with CIU and of 20 sex and age matched controls. Moreover, we assessed soluble CD154 a marker of immune cell activation, predominantly memory T cells. When patients were divided depending an their response to the autologous serum skin test (ASST), three different groups were encountered: group 1 (n=11): with negative ASST-, group 2 (n=11): positive ASST (ASST+) with normal lymphocyte counts and group 3 (n=7): ASST+ with low lymphocyte counts (< 1500 cells/mm3). A significant increase in CD19+ percentage and not in the absolute count (P < 0.05) was observed in group 1 as compared to controls and to the other groups. In contrast, CD30+, CD45RO+ and CD4+/CD45RO+ percentages and biologically active soluble CD154 levels were significantly higher (P < 0.05) in group 3 as compared to group 1 or to controls. In ASST positive groups, CD45RO+ and CD4+/CD45RO+ positiveness correlates with wheal diameter. In conclusion, memory cells may play a role in these different types of patients and in understanding CIU pathogenesis.

Adult↗

PubMed2001

Comparative evaluation of surgical stress of laparoscopic and open surgeries for colorectal carcinoma.

PURPOSE: To objectively evaluate the benefits of laparoscopic procedures for colorectal carcinoma, a prospective study to measure the stress response to laparoscopic surgery (n = 15) compared with open surgery (n = 12) was undertaken. In addition, to compare the various parameters relevant to surgical stress, the major surgery group (transthoracic esophagectomy for esophageal carcinoma, n = 4; and left upper abdominal evisceration for gastric carcinoma, n = 3) was assigned. METHODS: Peripheral blood samples were obtained to measure serum interleukin-6, C-reactive protein, peripheral leukocytes, and lymphocyte counts. Additionally, the level of lymphocyte apoptosis was quantified using flow cytometry. RESULTS: The interleukin-6 and C-reactive protein levels were significantly greater in the open group than in the laparoscopy group one day (P < 0.05) and two days (P < 0.05) after surgery, respectively. In the laparoscopy group, lymphocyte counts were significantly higher than in the open group two days after surgery. The laparoscopy and open groups did not differ significantly in their lymphocyte apoptotic index. In the major surgery group, the apoptotic index was significantly higher than in either the laparoscopy group or the open group in the early postoperative period. CONCLUSION: Changes in the various parameters pertinent to surgical stress evaluated in this study suggest that laparoscopic surgery for colorectal carcinoma leads to less postoperative stress than conventional open surgery.

Aged↗