Summary
Monocytes play a key role in the immune response to trauma and infection. Is monocyte function already altered before surgery in terms of cell activation? On admission, serum neopterin was at or above 9 nmol/l in 50.2% and serum IL-6 was detectable (> 4 pg/ml) in 10.5% of 227 patients electively undergoing major abdominal surgery. Mean values of CRP (0.8 vs. 3.6),α-1-antitrypsin (267 vs. 376), albumin (4.0 vs. 3.5), prealbumin (27.0 vs. 17.9, all at p<0.01) were significantly different in patients with or without monocyte activation (neopterin > 9 nmol/l and IL-6>4 pg/ml). There was a significant correlation between neopterin and the acute phase proteins (all at p<0.01). The data reflect a “primed” state at least of some parts of the immune system in a subgroup of preoperative patients potentially affecting their response to surgical trauma and bacterial contamination.
Zusammenfassung
Monozyten besitzen eine Schlüsselrolle bei der Immunantwort auf Trauma und Infektion. Kann eine Änderung der Monozytenfunktion bereits präoperativ nachgewiesen werden? Zum Zeitpunkt der stationären Aufnahme lagen die Serum-Neopterinspiegel bei 52% von 227 elektiven, abdominal-chirurgischen Patienten über 9 nmol/l und Serum-IL-6 war bei 10,5% nachweisbar (über 4 pg/ml). Die Mittelwerte von CRP (0,8 vs. 3,6 mg/dl), α-1-Antitrypsin (267 vs. 376 g/l), Albumin (4,0 vs. 3,5 g/dl), Präalbumin (27,0 vs. 17,9 mg/dl, alle p<0,01) unterschieden sich signifikant bei Patienten mit und ohne Monozytenaktivierung (Neopterin > 9 nmol/l und IL-6>4 pg/ml). Zwischen Neopterin und den Akute-Phase-Proteinen bestand eine signifikante Korrelation (alle p<0,01). Bereits präoperativ konnte bei einer Gruppe von Patienten eine Aktivierung von Teilbereichen des Immunsystems nachgewiesen werden, die potentiell die Immunantwort auf das operative Trauma und die intraund postoperative bakterielle Kontamination beeinflußt.
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Haupt, W., Hohenberger, W., Klein, P. et al. Detection of neopterin, interleukin-6 and acute-phase proteins as parameters of potential monocyte activation in preoperative patients. Infection 23, 263–266 (1995). https://doi.org/10.1007/BF01716282
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DOI: https://doi.org/10.1007/BF01716282