Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

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Spies, C.D. et al.

Spies, von Dossow, Eggers, Jetschmann, El-Hilali, Egert, Fischer, Schröder, Höflich, Sinha, Paschen, Mirsalim, Brunsch, Hopf, Marks, Wernecke, Pragst, Ehrenreich, Müller, Tonnesen, Oelkers, Rohde, Stein, Kox,

Altered cell-mediated immunity and increased postoperative infection rate in long-term alcoholic patients.

BACKGROUND: Preoperative alteration of T cell-mediated immunity as well as an altered immune response to surgical stress were found in long-term alcoholic patients. The aim of this study was to evaluate perioperative T cell-mediated immune parameters as well as cytokine release from whole blood cells after lipopolysaccharide stimulation and its association with postoperative infections. METHODS: Fifty-four patients undergoing elective surgery of the aerodigestive tract were included in this prospective observational study. Long-term alcoholic patients (n = 31) were defined as having a daily ethanol consumption of at least 60 g and fulfilling the Diagnostic and Statistical Manual of Mental Disorders for either alcohol abuse or alcohol dependence. The nonalcoholic patients (n = 23) were defined as drinking less than 60 g ethanol/day. Blood samples to analyze the immune status were obtained on morning before surgery and on the morning of days 1, 3, and 5 after surgery. RESULTS: Basic patient characteristics did not differ between groups. Before surgery, the T helper 1:T helper 2 ratio (Th1: Th2) was significantly lower (P < 0.01), whereas plasma interleukin 1beta and lipopolysaccharide-stimulated interleukin 1ra from whole blood cells were increased in long-term alcoholic patients. After surgery, a significant suppression of the cytotoxic lymphocyte ratio (Tc1:Tc2), the interferon gamma:interleukin 10 ratio from lipopolysaccharide-stimulated whole blood cells, and a significant increase of plasma interleukin 10 was observed. Long-term alcoholics had more frequent postoperative infections compared with nonalcoholic patients (54%vs. 26%; P = 0.03). CONCLUSIONS: T helper cell-mediated immunity was significantly suppressed before surgery and possibly led to inadequate cytotoxic lymphocyte and whole blood cell response in long-term alcoholic patients after surgery. This altered cell-mediated immunity might have accounted for the increased infection rate in long-term alcoholic patients after surgery.[1]

References

Altered cell-mediated immunity and increased postoperative infection rate in long-term alcoholic patients. Spies, C.D., von Dossow, V., Eggers, V., Jetschmann, G., El-Hilali, R., Egert, J., Fischer, M., Schröder, T., Höflich, C., Sinha, P., Paschen, C., Mirsalim, P., Brunsch, R., Hopf, J., Marks, C., Wernecke, K.D., Pragst, F., Ehrenreich, H., Müller, C., Tonnesen, H., Oelkers, W., Rohde, W., Stein, C., Kox, W.J. Anesthesiology (2004) [Pubmed]

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