Does Impaired Th1/Th2 Balance Cause Postoperative Infectious Complications in Colorectal Cancer Surgery?

Background Recent studies have shown that the Th1/Th2 balance shifts toward Th2 dominance in cancer-bearing state or under surgical stress. This study was designed to investigate whether perioperative impaired Th1/Th2 balance is associated with the occurrence of postoperative infection following col...

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Bibliographic Details
Published in:The Journal of surgical research 2007-05, Vol.139 (1), p.15-21
Main Authors: Matsuda, Akihisa, M.D, Furukawa, Kiyonori, M.D, Suzuki, Hideyuki, M.D, Kan, Hayato, M.D, Tsuruta, Hiroyuki, M.D, Matsumoto, Satoshi, M.D, Shinji, Seiichi, M.D, Tajiri, Takashi, M.D
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
colorectal cancer
Colorectal Neoplasms - immunology
Colorectal Neoplasms - surgery
Cytokines - biosynthesis
Female
General aspects
Humans
Infection - etiology
Infection - immunology
Leukocyte Count
Male
Medical sciences
Middle Aged
Postoperative Complications - etiology
Postoperative Complications - immunology
postoperative infection
Serum Albumin - analysis
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
surgical stress
Th1 Cells - immunology
Th1/Th2 balance
Th2 Cells - immunology
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Summary:Background Recent studies have shown that the Th1/Th2 balance shifts toward Th2 dominance in cancer-bearing state or under surgical stress. This study was designed to investigate whether perioperative impaired Th1/Th2 balance is associated with the occurrence of postoperative infection following colorectal cancer surgery. Methods From 53 patients with colorectal cancer, peripheral blood samples were collected, before surgery, and on the 3rd, 7th, and 14th postoperative days. The proportions of CD4+ T-helper cells producing intracellular cytokines including interferon-γ (Th1 cells) and interleukin-4 (Th2 cells) were measured by flow cytometry. The patients were divided into two groups according to the presence (infected group) and absence (noninfected group) of postoperative infection. Results The infected group showed serum hypoalbuminemia and higher frequency of blood transfusion compared with the noninfected group. No significant difference in the proportion of Th1 cells was observed between the two groups. In contrast, the infected group showed significantly higher proportions of Th2 cells than the noninfected group (1.9 ± 0.9% for noninfected group and 2.8 ± 1.3% for infected group; P < 0.05). Regarding Th1/Th2 ratio, the infected group showed a lower ratio than the noninfected group (14.7 ± 8.8 for noninfected group and 9.0 ± 3.2 for infected group; P < 0.05). Throughout the postoperative period, the Th1/Th2 ratio in the infected group was significantly lower than that in the noninfected group. Conclusions This study demonstrated that perioperative Th2 dominance in addition to hypoalbuminemia and blood transfusion is associated with the occurrence of infection following colorectal cancer surgery. These results provide further information that may direct future treatments based on the Th1/Th2 concept focusing on decreasing the risk of postoperative infection.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2006.10.029