Hdl Handle:
http://hdl.handle.net/10147/209296
Title:
Cell response to surgery.
Authors:
Ni Choileain, Niamh; Redmond, H Paul
Affiliation:
Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland., nncl@eircom.net
Citation:
Arch Surg. 2006 Nov;141(11):1132-40.
Journal:
Archives of surgery (Chicago, Ill. : 1960)
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209296
DOI:
10.1001/archsurg.141.11.1132
PubMed ID:
17116807
Abstract:
OBJECTIVES: To describe the profound alterations in host immunity that are produced by major surgery as demonstrated by experimental and clinical studies, and to evaluate the benefits of therapeutic strategies aimed at attenuating perioperative immune dysfunction. DATA SOURCES: A review of the English-language literature was conducted, incorporating searches of the MEDLINE, EMBASE, and Cochrane collaboration databases to identify laboratory and clinical studies investigating the cellular response to surgery. STUDY SELECTION: Original articles and case reports describing immune dysfunction secondary to surgical trauma were included. DATA EXTRACTION: The results were compiled to show outcomes of different studies and were compared. DATA SYNTHESIS: Current evidence indicates that the early systemic inflammatory response syndrome observed after major surgery that is characterized by proinflammatory cytokine release, microcirculatory disturbance, and cell-mediated immune dysfunction is followed by a compensatory anti-inflammatory response syndrome, which predisposes the patient to opportunistic infection, multiple organ dysfunction syndrome, and death. Because there are currently no effective treatment options for multiple organ dysfunction syndrome, measures to prevent its onset should be initiated at an early stage. Accumulating experimental evidence suggests that targeted therapeutic strategies involving immunomodulatory agents such as interferon gamma, granulocyte colony-stimulating factor, the prostaglandin E(2) antagonist, indomethacin, and pentoxifylline may be used for the treatment of systemic inflammatory response syndrome to prevent the onset of multiple organ dysfunction syndrome. CONCLUSIONS: Surgical trauma produces profound immunological dysfunction. Therapeutic strategies directed at restoring immune homeostasis should aim to redress the physiological proinflammatory-anti-inflammatory cell imbalance associated with major surgery.
Language:
eng
MeSH:
Animals; Cytokines/*immunology; Humans; Immunity, Cellular/*physiology; Inflammation/*immunology; Laparoscopy; Microcirculation/immunology; *Surgical Procedures, Operative; Wounds and Injuries/*immunology
ISSN:
0004-0010 (Print); 0004-0010 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorNi Choileain, Niamhen_GB
dc.contributor.authorRedmond, H Paulen_GB
dc.date.accessioned2012-02-03T15:17:30Z-
dc.date.available2012-02-03T15:17:30Z-
dc.date.issued2012-02-03T15:17:30Z-
dc.identifier.citationArch Surg. 2006 Nov;141(11):1132-40.en_GB
dc.identifier.issn0004-0010 (Print)en_GB
dc.identifier.issn0004-0010 (Linking)en_GB
dc.identifier.pmid17116807en_GB
dc.identifier.doi10.1001/archsurg.141.11.1132en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209296-
dc.description.abstractOBJECTIVES: To describe the profound alterations in host immunity that are produced by major surgery as demonstrated by experimental and clinical studies, and to evaluate the benefits of therapeutic strategies aimed at attenuating perioperative immune dysfunction. DATA SOURCES: A review of the English-language literature was conducted, incorporating searches of the MEDLINE, EMBASE, and Cochrane collaboration databases to identify laboratory and clinical studies investigating the cellular response to surgery. STUDY SELECTION: Original articles and case reports describing immune dysfunction secondary to surgical trauma were included. DATA EXTRACTION: The results were compiled to show outcomes of different studies and were compared. DATA SYNTHESIS: Current evidence indicates that the early systemic inflammatory response syndrome observed after major surgery that is characterized by proinflammatory cytokine release, microcirculatory disturbance, and cell-mediated immune dysfunction is followed by a compensatory anti-inflammatory response syndrome, which predisposes the patient to opportunistic infection, multiple organ dysfunction syndrome, and death. Because there are currently no effective treatment options for multiple organ dysfunction syndrome, measures to prevent its onset should be initiated at an early stage. Accumulating experimental evidence suggests that targeted therapeutic strategies involving immunomodulatory agents such as interferon gamma, granulocyte colony-stimulating factor, the prostaglandin E(2) antagonist, indomethacin, and pentoxifylline may be used for the treatment of systemic inflammatory response syndrome to prevent the onset of multiple organ dysfunction syndrome. CONCLUSIONS: Surgical trauma produces profound immunological dysfunction. Therapeutic strategies directed at restoring immune homeostasis should aim to redress the physiological proinflammatory-anti-inflammatory cell imbalance associated with major surgery.en_GB
dc.language.isoengen_GB
dc.subject.meshAnimalsen_GB
dc.subject.meshCytokines/*immunologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshImmunity, Cellular/*physiologyen_GB
dc.subject.meshInflammation/*immunologyen_GB
dc.subject.meshLaparoscopyen_GB
dc.subject.meshMicrocirculation/immunologyen_GB
dc.subject.mesh*Surgical Procedures, Operativeen_GB
dc.subject.meshWounds and Injuries/*immunologyen_GB
dc.titleCell response to surgery.en_GB
dc.contributor.departmentDepartment of Surgery, Cork University Hospital, Wilton, Cork, Ireland., nncl@eircom.neten_GB
dc.identifier.journalArchives of surgery (Chicago, Ill. : 1960)en_GB
dc.description.provinceMunster-

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