REVIEW
Pathogenesis of Immunosuppression after Surgical Stress
Hironori Tsujimoto, Satoshi Ono and Hidetaka Mochizuki
Department of Surgery, National Defense Medical College
Immunosuppression after surgical stress frequently kills critically ill patients, creating critical problem in improving mortality in such patients. Surgical stress induces the deactivation and systemic loss of leukocytes, including monocytes, lymphocytes, and dendritic cells. Surgical stress also produces proapoptotic factors that may induce systemic loss of leukocytes and parenchymal cells. Studies of septic rodents have shown that apoptosis is prevented by administering antiapoptotic agents, improving survival from sepsis. In short, surgical stress induces extensive loss of immunocompetent cells via apoptosis, which in turn, may lead to severe microbial infection, suggesting that the regulation of unfavorable apoptosis and adoptive transfer of lost cells is effective as a therapeutic approach to immunosuppression associated with surgical stress.
Key words
surgical stress, immunosuppression, apoptosis
Jpn J Gastroenterol Surg 40: 1456-1465, 2007
Reprint requests
Hironori Tsujimoto Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359-8513 JAPAN
Accepted
February 28, 2007
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