Preoperative Toll-like Receptor Expression in Monocytes is Associated with Host Immunological Responses Following Gastrointestinal Surgery

• Published in: World journal of surgery 2011-02, Vol.35 (2), p.365-371
• Main Authors: Ono, Satoshi, Tsujimoto, Hironori, Hiraki, Shu-ichi, Kinoshita, Manabu, Hase, Kazuo
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Biological and medical sciences; Cancer; Cardiac Surgery; CD14 antigen; CD14 Expression; Cytokines; Female; Flow Buffer; gamma -Interferon; Gastrointestinal Neoplasms - surgery; General aspects; General Surgery; Humans; Immune response; Inflammation; Interleukin 1; Lipopolysaccharides; Male; Mean Fluorescence Intensity; Medical sciences; Medicine; Medicine & Public Health; Monocytes; Monocytes - immunology; Peripheral Blood Monocyte; Peripheral blood mononuclear cells; Postoperative Complications - immunology; Postoperative Infectious Complication; Preoperative Period; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Thoracic Surgery; TLR2 protein; TLR4 protein; Toll-like receptors; Toll-Like Receptors - biosynthesis; Tumor necrosis factor- alpha; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-010-0839-z

Background The present study was designed to evaluate the relationship between preoperative Toll-like receptor (TLR) expression in peripheral blood monocytes (PBMC) and the postoperative inflammatory cytokine secretion from PBMC, as well as the postoperative infectious complications in patients with gastrointestinal cancer. Methods Peripheral blood monocytes were isolated from 26 patients on the preoperative day and on postoperative day 1 (POD1). The monocytes were stained for CD14, TLR2, and TLR4 surface expression and stimulated ex vivo with lipopolysaccharide (LPS), after which the culture supernatant tumor necrosis factor alpha (TNFα), interleukin (IL)-1β, and interferon gamma (IFNγ) concentrations were measured in the culture supernatant. Postoperative clinical courses were monitored. Results There was a significant positive correlation between preoperative TLR4 expression and clinical stage in patients with gastrointestinal cancer. A significant negative correlation between preoperative TLR2 or TLR4 expression and the preoperative TNFα and IL-1β production was found. Furthermore, there was a significant negative correlation between preoperative TLR2 or TLR4 expression and postoperative inflammatory cytokine production. Conclusions Preoperative high expression of TLR on monocytes reduces the capacity for LPS-induced inflammatory cytokine production from monocytes. An analysis of preoperative TLR expression may therefore help to elucidate the systemic immunological response and the clinical course following gastrointestinal surgery.