RÉSUMÉ
OBJECTIVE: In this study, we test the hypothesis that off-pump coronary bypass surgery might result in less lymphocyte activation than on-pump coronary surgery. We also study the behavior of lymphocyte activation markers during and after surgery. BACKGROUND: Coronary artery bypass surgery is known to be associated with changes of inflammatory mediators, immune function, and early phase lymphocyte activation, which could cause postoperative lymphopenia and lymphocyte unresponsiveness. METHODS: We studied lymphocyte activation response in 28 patients randomized to off-pump (n = 13) or on-pump (n = 15) coronary artery bypass surgery. Expression of CD25, CD26, CD69, and DR on T (CD3+) and B (CD19+) lymphocytes on peripheral blood was assessed through flow cytometry. RESULTS: The response of T lymphocytes and their activation markers, as well as B lymphocytes and their activation markers, was similar after on- and off-pump surgery. Overall, T lymphocytes decreased to the lowest level 9 h after surgery and tended to increase later. For B lymphocytes, there was early reduction with increase on the 1st postoperative day. There was early activation of CD69+ and late activation of CD25+ on T lymphocytes. For B lymphocytes, there was early activation of CD69+ and late activation of DR+. CONCLUSIONS: (1) Compared to on-pump cardiopulmonary bypass, off-pump surgery does not reduce lymphocyte activation. (2) Coronary bypass surgery causes the early activation of lymphocytes, as evidenced by the increased expression of lymphocyte activation markers.
Sujet(s)
Lymphocytes B/métabolisme , Pontage cardiopulmonaire , Pontage aortocoronarien/méthodes , Maladie coronarienne/chirurgie , Activation des lymphocytes/physiologie , Lymphocytes T/métabolisme , Antigènes CD/biosynthèse , Antigènes CD19/biosynthèse , Antigènes de différenciation des lymphocytes T/biosynthèse , Lymphocytes B/immunologie , Marqueurs biologiques/sang , Antigènes CD3/biosynthèse , Maladie coronarienne/sang , Maladie coronarienne/immunologie , Dipeptidyl peptidase 4/biosynthèse , Femelle , Cytométrie en flux , Humains , Lectines de type C , Numération des lymphocytes , Mâle , Adulte d'âge moyen , Lésion de reperfusion myocardique/sang , Lésion de reperfusion myocardique/immunologie , Récepteurs à l'interleukine-2/biosynthèse , Facteurs de risque , Lymphocytes T/immunologie , Résultat thérapeutiqueRÉSUMÉ
The anti-depressive drug trifluoperazine (TFP) was studied on in vitro immune responses. TFP proved to be an inhibitor of lymphokine-activated killer (LAK) cells in its generative step, as well as in its effector phase. Natural killer (NK) activity and interleukin-2 (IL-2) or mitogen-induced lymphocyte proliferation were just as sensitive to the drug effects, whereas the division of tumor cells was more resistant. The mechanism through which TFP suppresses these lymphocytic systems remains unclear. It does not, however, affect an early stage of cellular activation as the addition of the drug as late as 24 h after the start of the culture was still inhibitory for lymphocyte mitogenesis. Neither the expression of CD25, nor that of CD56 was affected by TFP, and exogenous IL-2 was unable to overcome the suppression of proliferation. In relation to cell-mediated cytotoxicity, TFP partially interfered with the effector/target binding. However, addition of lectin to the assay did not overcome the inhibition of lysis produced by the drug. Although further work remains to be done, the effect of TFP on immune responses must be taken into consideration when treating immunosuppressed patients.