scholarly journals The immunosuppressive effects of volatile versus intravenous anesthesia combined with epidural analgesia on kidney cancer: a pilot randomized controlled trial

2020 ◽  
Vol 73 (6) ◽  
pp. 525-533
Author(s):  
Sergey Mihailovich Efremov ◽  
Victoria Sergeevna Kozireva ◽  
Gleb Borisovich Moroz ◽  
Marat Nikolaevich Abubakirov ◽  
Olga Sergeevna Shkoda ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
Epidural Analgesia ◽  
Kidney Cancer ◽  
T Lymphocyte ◽  
Lymphocyte Subpopulations ◽  
Cell Mediated Immunity ◽  
Inhalational Anesthesia ◽  
Intravenous Anesthesia ◽  
Thoracic Epidural ◽  
T Lymphocyte Subpopulations

Background: The aim of this study was to test the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity compared to total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia. Methods: Patients were randomly allocated to either propofol-based (intravenous anesthetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both groups. Amounts of natural killer cells, total T lymphocytes, and T lymphocyte subpopulations in the blood samples collected from the patients before surgery, at the end of the surgery and postoperative days 1, 3, and 7, were determined by flow cytometric analysis. The natural killer (NK) cell count served as the primary endpoint of the study, whereas the total T lymphocyte count and cell counts for T lymphocyte subpopulations were used as the secondary endpoint. . Results: Our study showed that there were no significant differences in the amount of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol- and sevoflurane-based anesthesia groups when the anesthesia was administered in combination with epidural analgesia. Conclusions: The results of this pilot study did not support the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity than that of total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia.

Impaired T-Lymphocyte Subpopulations and Deranged Profile of Immunologic Activation in Patients with Gaucher Disease Type I

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4915-4915
Author(s):  
Argiris S Symeonidis ◽  
George Theodorou ◽  
Constantina Repa ◽  
Theodore Marinakis ◽  
Panayiotis Tsaftaridis ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
T Lymphocyte ◽  
Gaucher Disease ◽  
Lymphocyte Activation ◽  
Absolute Number ◽  
Lymphocyte Subpopulations ◽  
Type I ◽  
Cd8 T Lymphocytes ◽  
T Lymphocyte Subpopulations ◽  
Hla Dr

Abstract Patients with Gaucher disease exhibit substantial evidence of impairment of their immune system, namely, increased serum levels of proinflammatory cytokines and immunoglobulins, and increased incidence of B-cell malignancies, such as non-Hodgkin’s lymphoma, MGUS and multiple myeloma. We investigated peripheral blood T-lymphocyte subpopulations with dual color flow cytometry, as well as the direction of T-lymphocyte activation, by using intracytoplasmic immunostaining for IL-2, IL-4, IL-10 and IFN-gamma, on resting CD4+ and CD8+ T-lymphocytes and following activation with PMA- 1 with the presence of Brefeldin-A. Evaluations were performed on 16 patients with type I Gaucher disease and on 17 healthy controls. Patients had significantly decreased absolute lymphocyte count (1621±684 vs 2148±566/mm3, p=0.013), CD3+ (1197±478 vs 1508±431/mm3, p=0.045) and CD4+ T-lymphocytes (658±245 vs 945±253/mm3, p=0.021), but not CD8+ T-lymphocytes (491±331 vs 486±189/mm3, p: n.s.), resulting in a significant reduction of the CD4/CD8 ratio (1.59±0.68 vs 2.16±0.83, p=0.041). The populations of naive CD4+CD45RA+ and of memory CD4+CD45RO+ T-lymphocytes were also significantly decreased (218±128 vs 432±179/mm3, p=0.0005 and 484±185 vs 631±231/mm3, p=0.056 respectively), however, CD8+CD45RA+ and CD8+CD45RO+ subpopulations did nor differ significantly, when compared to controls. CD3−CD56+, but not CD3+CD56+ lymphocytes were also decreased (131±82 vs 199±97/mm3, p=0.037). Patients had higher percentages of CD8+ (29.2±9.7 vs 23.5±6.8%, p=0.042), CD8+CD45RA+ (22.1±6.2 vs 18.3±5.0%, p=0.046) and CD8+CD45RO+ T-lymphocytes (13.2±6.2 vs 9.6±3.7%, p=0.027), as well as of activated CD8+HLA-DR+ (0.93±0.68 vs 0.48±0.21%, p=0.008) and CD4+HLA-DR+ T-lymphocytes (1.77±0.93 vs 1.09±0.48%, p=0.008). Moreover, although both, the absolute number and the percentage of CD20+ B-lymphocytes were similar, patients exhibited significantly increased absolute number and percentage of CD5+CD20+ B-lymphocytes (1.63±0.55 vs 0.64±0.37% p=0.00002 and 29±20 vs 13±8/mm3, p=0.011, respectively). Finally, patients with Gaucher disease had significantly increased resting TH2-polarized CD4+T-lymphocytes (CD4+IL-10+: 0.41±0.29 vs 0.24±0.11%, p=0.045) and TH1-polarized CD8+ T-lymphocytes (CD8+IFNγ+: 0.15±0.07 vs 0.08±0.04%, p=0.005, CD8+IL10+: 0.22±0.08 vs 0.32±0.014, p=0.052, and IFNγ+/IL4+ ratio among the CD8+ population 2.54±2.1 vs 1.08±0.91, p=0.018). Following mitogenic activation a very significant impairment of obtaining the TH1 phenotype was observed (CD4+IL2+ lymphocytes 33.7±17.1 vs 65.4±6.1%, p<0.00001). The above findings suggest that in patients with Gaucher disease there is a significant numerical impairment of T-helper lymphocytes and a shift towards TH-2 direction of lymphocyte activation. These findings may explain the rarity of autoimmune manifestations despite the chronic inflammatory reaction, as well as the increased incidence of lymphoid malignancies, which has been reported among patients suffering from this disease.

Novel Human CD4+ T Lymphocyte Subpopulations Defined by CD300a/c Molecule Expression.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2304-2304
Author(s):  
Derek N.J. Hart ◽  
Min Rao ◽  
Xinsheng Ju ◽  
Georgina J. Clark
Keyword(s):  
Gene Expression ◽  
T Lymphocytes ◽  
T Lymphocyte ◽  
Lymphocyte Subpopulations ◽  
Chromosome 17 ◽  
Lymphocyte Population ◽  
Membrane Glycoproteins ◽  
T Lymphocyte Subpopulations ◽  
Treg Population ◽  
Cd4 Lymphocytes

Abstract CD300a and CD300c are leukocyte membrane glycoproteins encoded by genes in the CD300 complex on human chromosome 17. These molecules function as immunoregulatory molecules that initiate triggering and inhibitory responses following ligation with ligands. The CMRF-35 monoclonal antibody binds to an epitope common to both molecules, expressed on most human leukocyte populations, apart from B lymphocytes and a subpopulation of CD4+ and CD8+ T lymphocytes. We used it to study the distribution of the CD300a and CD300c molecules on peripheral blood CD4+ T lymphocytes and defined novel CD300a/c++ , CD300a/c+ and CD300a/c− CD4+ T lymphocyte subpopulations. Resting peripheral CD4+ T lymphocytes express CD300a mRNA and very low amounts of CD300c. Activation results in an initial decrease in CD300a gene expression before an increase in both CD300a and CD300c gene expression. The upregulated expression of these genes was associated with increased CMRF-35 binding to activated T lymphocytes. The CD300a/c− fraction of CD4+ T lymphocytes proliferated to a greater extent than the CD300a/c++ fraction, in response to mitogens or allogeneic antigen. The poor proliferation of the CD300a/c++CD4+ in response to mitogens was explained by increased apoptosis within this subpopulation. The recall antigen, tetanus toxoid, stimulated the CD300a/c++CD4+CD45RO+ but not the CD300a/c−CD4+CD45RO+ subpopulation. Resting CD300a/c++CD4+ lymphocytes express low levels of IFNγ mRNA. Within 18 hours following in vitro activation, CD300a/c++CD4+ lymphocytes express more IFNγ mRNA and protein compared to the CD300a/c−CD4+ lymphocytes, however, after 24 hours both the CD300a/c+ and CD300a/c− CD4+ T lymphocytes were able to produce IFNγ. Th1 and Th17 effector populations are found within the CD300a/c++CD4+ T lymphocyte population, whilst the Treg population are restricted to the CD300a/c−CD4+ T lymphocyte population. Thus, CD300a/c subdivides CD4+ subpopulations into functional populations with the potential to immunoregulate immune and allogeneic responses. We are currently monitoring these populations in allogeneic haemopoietic stem cell recipients.

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