ISSN: 2577-4379
Authors: Fishman B, Tapbergenov T, Kuprin P, Turmakhanov S, Saydayev Z, Kushpita A, Martynov I, Karasev D, Yukhno M and Rumyantsev Y*
Already in the 60-70s of the last century, it was firmly established that, regardless of the initial general condition of the patient and the level of his immunoreactivity, the surgical operation itself has an adverse effect on the immune system and causes the development of immunodeficiency. In the phagocytic system of immunity, under the influence of surgical intervention, both quantitative (lowering the number of main phagocytic cells: neutrophils and monocytes) and qualitative changes (lowering the ability of phagocytes to capture, kill and digest microorganisms) are observed. It is important to note that during the operation, the population of phagocytic cells that is closest to the site of intervention is more affected. Cells of the monocyte-macrophage system play an important role in the induction of both cellular and humoral immune response. Changes in humoral immunity consist in lowering blood level of all classes of immunoglobulins (IgG, IgA, IgM) and especially IgG – the main component of humoral immunity. In the cellular immunity, under the influence of surgery, quantitative and qualitative changes are also observed. First of all, the total number of lymphocytes decreases and the level of T-lymphocytes decreases while maintaining the ratio between the two main subpopulations: T-helpers and T-suppressors. Cytokines play a major role in the implementation of the inflammatory response to surgical trauma. The local release of cytokines - interleukin-1 (IL-1), -6 (IL-6), tumor necrosis factor (TNF) coordinates the local inflammatory response at the site of injury, inducing neutrophil chemotaxis to the area of inflammation. Cytokines induce fever and acute phase reactions, mobilize neutrophils from the bone marrow and cause lymphocyte proliferation. The action of cytokines iscomplex, to a certain extent, interdependent. Cytokine production reflects on the invasiveness of surgery. So, it is minimal in laparoscopic procedures and maximal in prosthetic joints, large vascular and abdominal operations.
Keywords: Surgical Stress; Cytokines; Immunology; Neuroendocrine System
