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Neutrophil phenotype and function in partial hepatectomy in man

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Abstract

Purpose

Hepatic resections are still associated with considerable morbidity mainly because of postoperative infection. Adequate function of neutrophils is a crucial element in host defense. The aim of the study was to characterize neutrophils during partial hepatectomy.

Methods

Fourteen patients undergoing partial liver resection were enrolled. Twenty-four hours pre-, intra- (after induction of anesthesia, after preparation of the liver, and 15 min after release of the Pringle maneuver), as well as postoperatively (3 h after Pringle; 24, 48, and 120 h after surgery), blood samples were obtained. In addition, healthy volunteers (n = 5) were investigated. Adhesion molecules (CD 62, CD 18), Fcy receptors (CD 16, CD 32), and phagocytosis by neutrophils were characterized by fluorescence-activated cell sorter analysis. Spontaneous and stimulated (formyl-methionyl-leucyl-phenylalanine) oxygen radical generation was measured by lucigenin-enhanced chemiluminescence.

Results

Numeric upregulation of CD 62 and CD 18 on neutrophils was seen before the use of Pringle maneuver and persisted thereafter (p < 0.05). Spontaneous numeric expression of Fcy receptors (CD16 and CD 32) was unchanged during liver dissection but downregulated after Pringle maneuver was opened (p < 0.05). Although numeric Fcy receptors were downregulated, phagocytosis of heterologous opsonized Escherichia coli bacteria by neutrophils was unaffected. Spontaneous oxygen radical production peaked sharply 15 min after release of the Pringle maneuver (p < 0.05), contrary to stimulated oxygen radical production, which was depressed 3 h after the release of the Pringle maneuver (ns).

Conclusions

Uneventful partial hepatectomy in man resulted already in a significant change in the phenotype but in less significant changes in the functions of neutrophils.

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Abbreviations

CD:

Cluster of differentiation

CVP:

Central venous pressure

Cpm:

Counts per minute

FACScan:

Fluorescence-activated cell analysis

FcyR:

Fc gamma receptor

FMLP:

Formyl-methionyl-leucyl-phenylalanine

Fig:

Figure

HBSS:

Hank’s buffered salt solution

ICAM:

Intercellular adhesion molecule

MFI:

Mean fluorescence intensity

PBS:

Phosphate buffered saline

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Authors and Affiliations

  1. Department of General Surgery, Johann-Wolfgang Goethe-University, Theodor- Stern- Kai 7, 60590, Frankfurt, Germany

    Katharina Holzer, Dennis Hofmann, Elsie Oppermann, Christian Mönch & Wolf-Otto Bechstein

  2. Department of Internal Medicine, Johann-Wolfgang Goethe-University, Frankfurt, Germany

    Stefan Zeuzem

  3. Department of Trauma Surgery, Johann-Wolfgang Goethe-University, Frankfurt, Germany

    Dirk Henrich

Authors
  1. Katharina Holzer
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  2. Dennis Hofmann
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  3. Elsie Oppermann
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  4. Stefan Zeuzem
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  5. Christian Mönch
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  6. Dirk Henrich
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  7. Wolf-Otto Bechstein
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Correspondence to Katharina Holzer.

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Holzer, K., Hofmann, D., Oppermann, E. et al. Neutrophil phenotype and function in partial hepatectomy in man. Langenbecks Arch Surg 395, 643–653 (2010). https://doi.org/10.1007/s00423-009-0557-x

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  • DOI: https://doi.org/10.1007/s00423-009-0557-x

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