concanavalin-a and Postoperative-Complications

Topics: Cells, Cultured; Concanavalin A; Creatinine; Cytomegalovirus; Cytomegalovirus Infections; Ganciclovir; Humans; Immunosuppressive Agents; Kidney Transplantation; Leukocytes; Polymerase Chain Reaction; Postoperative Complications; T-Lymphocytes

Preoperative autologous blood donation (PABD) has been shown to decrease natural killer (NK) cell function in cancer patients, raising concerns about an increased cancer recurrence risk owing to PABD. It is unclear whether PABD leads to other immunomodulatory effects that might affect more short-term risks like postoperative infectious complications in surgical patients. Lymphocyte subsets (CD4+ T cells, CD8+ T cells, B cells, NK cells) were determined in 86 consecutive patients donating 2 units of autologous whole blood prior to elective hip replacement surgery. In addition, cytokine secretion patterns of monocytes [tumour necrosis factor (TNF)] and lymphocytes [interferon-gamma, interleukin (IL)-2, IL-4, IL-10] upon stimulation were determined in a random subgroup of 58 patients. Analyses were performed immediately before the first donation and on the day prior to operation. Granulocytes increased during PABD by 4.6% (P < 0.01). Lymphocytes decreased by 8.8% (P < 0.01), accompanied by a relative rise in CD4+ T cells by 10.7% (P < 0.01) and in B cells by 10.3% (P < 0.01), and a fall of NK cells by 20.8% (P < 0.01). Stimulated TNF secretion of monocytes was suppressed (-12.3%, P < 0.01). The effect on the reactivity of lymphocytes and the T helper 1 (Th1)/Th2 balance were variable. The observed changes of innate and cellular immunity might influence the risk of perioperative infectious complications.

Topics: Aged; Arthroplasty, Replacement, Hip; Blood Donors; Blood Transfusion, Autologous; Cells, Cultured; Cohort Studies; Concanavalin A; Cytokines; Disease Susceptibility; Elective Surgical Procedures; Female; Humans; Immunity, Cellular; Immunocompromised Host; Infections; Iron; Lymphocyte Activation; Lymphocyte Count; Lymphocyte Subsets; Male; Middle Aged; Monocytes; Phytohemagglutinins; Postoperative Complications; Preoperative Care; Sampling Studies; Th1 Cells; Th2 Cells

Several basic studies have demonstrated that monocyte chemoattractant protein-1 (MCP-1) influences type 2 cytokine production and cell-mediated immunity. However, there have been few reports on the changes in serum MCP-1 levels in patients undergoing major thoracoabdominal surgery. In this study, we examined the kinetics of serum MCP-1 post-operatively and clarified its significance regarding the extent of surgical stress.. Seventeen patients who underwent surgical operations were included in this study. All of them were fed by total parenteral nutrition to deliver the same amount of calories and nitrogen. Of the severely stressed group, nine patients underwent esophagectomy with thoracotomy. Of the group of moderately stressed group, eight patients underwent gastric or colorectal surgery. Serum MCP-1 and interleukin-6 (IL-6) were measured after operation. Cell-mediated immunity was measured by concanavalin A- or phytohemagglutinin-stimulated lymphocyte proliferation on the seventh post-operative day.. Serum MCP-1 and IL-6 were increased immediately after surgery in both groups. The level of MCP-1 was significantly higher in the group of severely stressed patients than in the moderately stressed group. Concanavalin A or phytohemagglutinin-stimulated lymphocyte proliferation was significantly lower in the severely stressed group than in the moderately stressed group.. These results indicate that serum MCP-1 levels are directly correlated, and cell-mediated immunity inversely correlated, with the severity of surgical stress.

Topics: Aged; Cell Division; Chemokine CCL2; Concanavalin A; Energy Intake; Esophagectomy; Female; Humans; Interleukin-6; Lymphocytes; Male; Middle Aged; Nitrogen; Phytohemagglutinins; Postoperative Complications; Severity of Illness Index; Stress, Physiological

Histopathological and lectin-histochemical characteristics were studied in the lining epithelium of postoperative maxillary cysts (POMC).. Histological (HE, PAS, AB), immunohistochemical (CD3 and L26) and lectin (wheat germ agglutinin, WGA; Ulex europaeus agglutinin I, UEA-I; concanavalin A, ConA) stainings were performed in the 360 POMC specimens. The number of goblet cells and inflammatory cells was counted and statistically analyzed.. The lining epithelium was classified into three types based on histopathological characteristics; pseudostratified ciliated epithelium (pSCE), transitional epithelium (TE) and stratified squamous epithelium (SSE). Local infiltration of inflammatory cells into the cyst wall was associated with an increased number of goblet cells in the lining epithelium. The observed association between the infiltration of inflammatory cells and an increase in the number of goblet cells was statistically significant in groups with lining pSCE and TE. Glycoconjugate histochemical analysis revealed that the surfaces of the lining epithelium with squamous metaplasia showed an increased degree of staining reactivity with UEA-I, whereas the staining reactivity with ConA was reduced. Goblet cells were able to be stained with WGA and UEA-I, but showed extremely low reactivity with ConA.. Changes in the glycoconjugate expression of the metaplastic lining epithelium and goblet cell development play an important role in the local defense mechanisms against inflammatory factors in POMC.

Topics: Adult; Aged; Aged, 80 and over; Alcian Blue; Analysis of Variance; B-Lymphocytes; Cilia; Coloring Agents; Concanavalin A; Epithelial Cells; Epithelium; Female; Fluorescent Dyes; Goblet Cells; Humans; Immunohistochemistry; Jaw Cysts; Linear Models; Male; Maxillary Diseases; Metaplasia; Middle Aged; Neutrophils; Periodic Acid-Schiff Reaction; Plant Lectins; Plasma Cells; Postoperative Complications; T-Lymphocytes; Wheat Germ Agglutinins

The distribution of glycoconjugates in normal maxillary sinus tissues, in cases of maxillary sinusitis and in postoperative maxillary cysts (POMC), was examined using seven different lectins as probes. The results showed that wheatgerm agglutinin (WGA), peanut agglutinin (PNA), Ulex europaeus agglutinin-1 (UEA-1), Ricinus communis agglutinin-1 (RCA-1), and concanavalin A (ConA) strongly react with the cilia and goblet cells. The binding of WGA, PNA, UEA-1, and RCA-1 was increased in maxillary sinusitis and POMC compared with normal maxillary sinus epithelium, whereas that of ConA was decreased. The decreased binding of ConA suggested that there were fewer mannoside residues in the maxillary sinus epithelium in the inflammatory lesion. The PNA bound to the cilia, goblet cells and mucous glandular cells in maxillary sinusitis and POMC, but not in normal, uninflamed cells, indicating that D-galactose was produced by the inflammatory condition. Similar binding patterns of PNA and RCA-1 were found in the cilia and on the surface of the epithelium and in the goblet cells. It is assumed that the carbohydrate moiety in the sinus mucosa is altered in inflammatory conditions.

Topics: Acetylgalactosamine; Acetylglucosamine; Biomarkers; Cilia; Concanavalin A; Cysts; Epithelium; Galactose; Glycoconjugates; Goblet Cells; Histocytochemistry; Humans; Lectins; Mannosides; Maxillary Sinus; Maxillary Sinusitis; N-Acetylneuraminic Acid; Paranasal Sinus Diseases; Peanut Agglutinin; Plant Lectins; Plants, Toxic; Postoperative Complications; Respiratory Mucosa; Ricinus communis; Wheat Germ Agglutinins

Surgery is a commonly performed procedure which produces substantial alterations in immune function in both humans and animals. To better understand the mechanism of surgery-induced immunomodulation, the present study investigated the effect of the opioid antagonist naltrexone on surgery-induced immune alterations in rats. Based on previous investigations in our laboratory, rats underwent a 6-cm laparotomy with no internal manipulation and immunological assessments were completed 24 h following the surgical procedure. Naltrexone was administered at the time of surgery and every 4 h thereafter until immune assessment. Results showed that naltrexone attenuated the surgery-induced decrease in natural killer cell cytotoxicity, B-cell proliferation, T-cell proliferation, and production of the cytokine IFN-gamma. These results are among the first to show that pharmacological antagonism of opioid receptors can prevent deleterious immune changes in the postoperative state, suggesting a detrimental role of the endogenous opioids in surgical procedures.

Topics: Abdomen; Animals; B-Lymphocytes; Bacterial Toxins; Concanavalin A; Enterotoxins; Humans; Interferon-gamma; Killer Cells, Natural; Lymphocyte Activation; Male; Naltrexone; Peritoneal Cavity; Postoperative Complications; Rats; Rats, Inbred Lew; Spleen; Superantigens; Surgical Procedures, Operative; T-Lymphocytes

This study was designed to evaluate monocyte calcium concentration and mobilization in normal and septic surgical patients.. Monocytes were isolated from 15 "septic" surgical patients, washed, and loaded with the fluorescent calcium chelator, FURA-2. Monocytes from 20 normal volunteers served as controls. Intracellular calcium concentration ([Ca2+]i) was measured by means of fluorescent spectrophotometry before, during, and after stimulation with concanavalin A. Differences were evaluated for statistical significance by analysis of variance. The study was repeated using normal monocytes preincubated in "septic" serum and "septic" monocytes preincubated in normal serum. Additional paired whole blood specimens were obtained from the control group and were incubated with Escherichia coli endotoxin. Monocytes were then isolated and evaluated as described.. Sepsis was associated with significantly low resting monocyte calcium concentrations. Although concanavalin A stimulation resulted in marked calcium mobilization in both normal and septic cells, final cellular calcium concentration was significantly lower in the stimulated "septic" monocytes. Similar alterations were seen in normal cells incubated with septic serum, but could not be reproduced by incubation with endotoxin. This deficiency could not be corrected in septic cells incubated in normal serum.. Sepsis is associated with a significant alteration of monocyte calcium dynamics in both resting and stimulated cells. These changes appear to be modulated by a serum factor other than endotoxin.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Calcium; Case-Control Studies; Concanavalin A; Female; Humans; Lymphocyte Activation; Male; Middle Aged; Monocytes; Postoperative Complications; Spectrometry, Fluorescence; Systemic Inflammatory Response Syndrome; Water-Electrolyte Balance

To determine the value of serum concentrations of interleukin-6 (IL-6), C-reactive protein, and glycosylation of alpha 1-acid glycoprotein as tools for diagnosing nosocomial infection in surgical intensive care unit (ICU) patients.. Prospective, consecutive entry study of patients with an anticipated stay of at least 24 hrs in a surgical ICU.. University hospital, a major provider of acute surgical care.. One hundred four consecutive patients admitted to the surgical ICU between March and June 1990.. Concentrations of IL-6, C-reactive protein, and glycosylation of alpha 1-acid glycoprotein were measured on days 1 and 6 after ICU admission. Clinical evaluation for infection was performed daily in a blinded fashion, i.e., without knowing the results of the acute-phase parameters.. On day 6 after surgery or trauma, nosocomial infection could be ascertained in 13 cases. The clinical parameter of fever > 38 degrees C had a sensitivity of 54% and a specificity of 90% to demonstrate nosocomial infection. Infected patients showed increased concentrations of IL-6 (p < .001), C-reactive protein (p < .001), and increased reactivity of alpha 1-acid glycoprotein to concanavalin A (p < .001) compared with patients without infections. By choosing appropriate cutoff values, IL-6 determinations had the highest specificity (97%), and C-reactive protein values had the highest sensitivity (85%) for diagnosing nosocomial infections. In uninfected patients, 81% of the IL-6 values, but only 29% of the C-reactive protein values, were back to the normal range on day 6 after injury.. Due to the rapid normalization after trauma, a single measurement of the serum IL-6 concentration may be useful to support or refute the clinical suspicion of nosocomial infection.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Body Temperature; C-Reactive Protein; Child; Concanavalin A; Cross Infection; Evaluation Studies as Topic; Female; Fever; Glycosylation; Humans; Intensive Care Units; Interleukin-6; Length of Stay; Male; Middle Aged; Orosomucoid; Postoperative Complications; Prospective Studies; Sensitivity and Specificity

Cell-mediated immunity was examined using 4 recall antigens in 102 critically ill surgical patients treated in an ICU. There were 4 (14%) deaths in 28 patients with positive reactions (R), compared to 33 (45%) deaths in 74 nonreactors (NR) (p less than .01). Thirty-seven of the patients were admitted after trauma, and mortality in this group was not significantly different between R and NR patients. Repeat testing in 40 NR patients who remained in the ICU for more than 7 days showed that 30 remained NR (70% mortality) and 10 became R (20% mortality, p less than .001). Peripheral blood lymphocytes from the patients showed a reduced response to concanavalin A, but a normal response to phytohemagglutinin and pokeweed mitogen. Mononuclear cells and granulocytes both showed a small increase in chemotactic response to casein, suggesting that the reduced response to skin testing may be partly due to defective T-cell function, rather than impaired phagocyte chemotaxis.

Topics: Adolescent; Adult; Aged; Chemotaxis, Leukocyte; Concanavalin A; Female; Humans; Immunity, Cellular; Infections; Lymphocyte Activation; Male; Middle Aged; Monocytes; Neutrophils; Phytohemagglutinins; Pokeweed Mitogens; Postoperative Complications; Skin Tests

Intrauterine thymectomy was carried out on days 36, 40, 48 and 68 (neonatal) of foetal life to investigate the role of thymus and emigration of thymocytes in the development of mitogenic (PHA, Con A, DxS) responses in the guinea pig. The results provide further evidence that emigration of thymocytes is a continuous process which takes place already at the time of demarcation between thymic cortex and medulla (before day 36 of gestation) and again immediately after birth. In the lymph nodes of guinea pigs thymectomized on day 36 in utero a small PHA and Con A responding cell population exists at the time of birth but not any more 3-4 mth later. This population is considered to depend on the transplacental thymic product(s). However, spleen and blood lymphocytes of animals thymectomized on day 36 in utero respond to PHA and Con A to some extent at the age of 3-4 mth, suggesting that the population emigrating before day 36 has a longer survival in the spleen and blood than in lymph nodes. Thymectomy at 40 days of gestation leaves an additional population which can express a good PHA and Con A response even in lymph nodes without a direct thymic influence. Responses to DxS were not significantly affected by the intrauterine thymectomy. Thus, intrauterine thymectomy at 36 days of gestation induces a severe but not complete T cell depletion in the guinea pig.

Topics: Animals; Animals, Newborn; Body Weight; Concanavalin A; Dextrans; Female; Guinea Pigs; Leukocyte Count; Lymph Nodes; Lymphocyte Activation; Lymphocytes; Mitogens; Phytohemagglutinins; Postoperative Complications; Pregnancy; Rosette Formation; Spleen; Thymectomy; Uterus

Pretreatment of the lung graft with concanavalin A (Con A) or chondroitin sulfate (CIS) was used to modify the lung allograft response after transplantation into moderately immunosuppressed (low doses of azathioprine and prednisone) recipients. Significant (p less than 0.05) prolongation of survival was observed after graft pretreatment. Pneumonia and rejection were the most frequent causes of death for all groups of dogs. However, only 3 out of 6 animals from each of the groups with pretreated grafts died of pneumonia or rejection, whereas 5 of the 6 animals in the control group died of these causes. Furthermore, when rejection occurred in the dogs with lung grafts pretreated with Con A or CIS, it was considerably delayed compared with the controls. Partial pressure of arterial oxygen, chest roentgenograms, and lung histology were good indicators of lung viability after transplantation.

Topics: Animals; Chondroitin; Chondroitin Sulfates; Concanavalin A; Dogs; Female; Graft Rejection; Lung; Lung Transplantation; Male; Pneumonia; Postoperative Complications; Radiography; Transplantation, Homologous