Monocyte-dependent suppression of T-cell function in postoperative patients and abdominal sepsis

• Verfasst von: Albertsmeier, Markus [VerfasserIn]
• Verfasst von: Bazhin, Alexandr V. [VerfasserIn]
• Titel: Monocyte-dependent suppression of T-cell function in postoperative patients and abdominal sepsis
• Verf.angabe: Markus Albertsmeier, Niclas J. Prix, Hauke Winter, Alexandr Bazhin, Jens Werner, and Martin K. Angele
• E-Jahr: 2017
• Jahr: December 2017
• Umfang: 17 S.
• Fussnoten: Gesehen am 13.09.2018
• Titel Quelle: Enthalten in: Shock
• Ort Quelle: Hagerstown, Md. : Lippincott, Williams & Wilkins, 1994
• Jahr Quelle: 2017
• Band/Heft Quelle: 48(2017), 6, Seite 651-656
• ISSN Quelle: 1540-0514
• DOI: doi:10.1097/SHK.0000000000000924
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1580956068

Abstract

Introduction: Surgical trauma causes inflammation and postoperative immunosuppression. Previous studies have shown a T-cell-dependent suppression of MHC II expression and other functions of antigen-presenting cells. The aim of this study was to determine which immune cell initiates postoperative immunosuppression and consecutive sepsis. Methods: We separated T-cells and monocytes in human abdominal surgery (n = 11) patients preoperatively as well as 24 h postoperatively and in patients who developed postoperative sepsis (n = 6). We analyzed their surface markers and then coincubated these cells with naïve preoperative cells of the other cell type, respectively. Cytokine secretion from naïve cells was measured by a multiplex immunoassay, serving as a bioassay for the function of the stimulating postoperative cell. Results: Surface marker analysis showed a postoperative suppression of CD3+ cells and the activation marker CD28 (P = 0.02), which was further reduced in septic patients. FACS analysis revealed a significant increase in CD14+ monocytes (P = 0.02) and CD14+CD86+, CD14+HLA-DR+ subpopulations 2 h postoperatively. In sepsis patients, HLA-DR expression was reduced compared with postoperative levels (P < 0.01). After coincubation with postoperative T-cells, secretion of IL-6 (P < 0.01) and IL-10 (P < 0.01) from naïve monocytes was increased, whereas T-cells from sepsis patients resulted in suppressed cytokine secretion. After coincubation with postoperative monocytes, secretion of IFN-gamma (P < 0.01) and IL-10 (P < 0.01) from naïve T-cells was significantly diminished, whereas monocytes from septic patients triggered only insignificant IL-10 secretion from naïve and septic T-cells. Conclusions: Our results show that in the early postoperative period, T-cells are suppressed but able to trigger the release of cytokines from monocytes, whereas activated monocytes seem to induce T-cell suppression. In sepsis patients, a global suppression of both cell types in terms of absolute numbers and function seems to occur.