1. Long-term alterations in monocyte function after elective cardiac surgery.
- Author
-
Zawadka M, Wahome J, Oszkiel H, Szeto WY, Cobb B, and Laudanski K
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Lectins, C-Type analysis, Macrophage Colony-Stimulating Factor biosynthesis, Male, Mannose Receptor, Mannose-Binding Lectins analysis, Middle Aged, Receptors, Cell Surface analysis, Cardiac Surgical Procedures adverse effects, Elective Surgical Procedures adverse effects, Monocytes physiology
- Abstract
Optimal immunological homoeostasis determines the long-term recovery of patients in the postoperative period. The functional adaptability of monocytes plays a pivotal role in adjusting the host's response to an insult, immunostasis and long-term health, and may help to determine successful recovery. We undertook a longitudinal analysis of the functional adaptability of monocytes in 20 patients undergoing heart surgery with cardiopulmonary bypass, as a model of severe stress. Using each patient's pre-cardiopulmonary bypass data as a baseline, we investigated the characteristics of peripheral blood monocytes' functional plasticity in-vitro before elective bypass, and three months afterwards. Approximately 30% of subjects showed diminished monocyte plasticity, as demonstrated by decreased monocyte differentiation into dendritic cells three months after bypass. Diminished monocyte functional plasticity was related to over-production of macrophage colony-stimulating factor. Adding a neutralising antibody to macrophage colony-stimulating factor corrected the monocytes' differentiation defect. Finally, patients with reduced monocyte plasticity had significantly elevated serum C-reactive protein, with a concomitant increase in cytomegalovirus IgG antibody titres, suggestive of the acquisition of immuno-suppressive traits. Our study shows that severe surgical stress resulted in a lasting immunological defect in individuals who had seemingly recovered., (© 2017 The Association of Anaesthetists of Great Britain and Ireland.)
- Published
- 2017
- Full Text
- View/download PDF