1.
Predicting neurological recovery after traumatic spinal cord injury by time-resolved analysis of monocyte subsets.
Heller, RA, Seelig, J, Crowell, HL, Pilz, M, Haubruck, P, Sun, Q, Schomburg, L, Daniel, V, Moghaddam, A, Biglari, B
Brain : a journal of neurology. 2021;(10):3159-3174
Abstract
Monocytes and lymphocytes elicit crucial activities for the regenerative processes after various types of injury. The survival of neurons exposed to mechanical and oxidative stress after traumatic spinal cord injury depends on a multitude of factors. In this study, we sought to evaluate a correlation between remission after traumatic spinal cord injury and the dynamics of monocyte subsets in respect to the lymphocytes' responsive potential, cytokine expression, patterns of trace element concentration and clinical covariates. We examined prospectively 18 (three female, 15 male) patients after traumatic spinal cord injury. Blood samples were drawn at admission and 4 h, 9 h, 12 h, 1 and 3 days as well as 1 and 2 weeks and 1, 2 and 3 months after the trauma. Analysis of cytokines (CCL2, IL-10, enolase 2, CXCL12, TGF-β1, TGF-β2) was performed using a multiplex cytokine panel. Plasma trace element concentrations of selenium, copper and zinc were determined by total reflection X-ray fluorescence analysis; neopterin, selenoprotein P (SELENOP) and ceruloplasmin (CP) by enzyme-linked immunosorbent assay; and selenium binding protein 1 (SELENBP1) by luminometric immunoassay. The responsive potential of lymphocytes was assessed using transformation tests. The monocyte subsets (classical, intermediate, and non-classical) and expression of CD14, CD16, CXCR4 and intracellular IL-10 were identified using a multi-colour flow cytometry analysis. The dynamics of the cluster of intermediate CD14-/CD16+/IL10+/CXCR4int monocytes differed significantly between patients with an absence of neurological remission (G0) from those with an improvement (G1) by 1 or 2 American Spinal Injury Association Impairment Scale (AIS) steps (Kruskal-Wallis Test, P = 0.010, G0 < G1, AIS+: 1 < G1, AIS+: 2) in the first 24 h. These dynamics were associated inversely with an increase in enolase and SELENBP1 14 days after the injury. In the elastic net regularized model, we identified an association between the increase of a subpopulation of intermediate CD14-/CD16+/IL10+/CXCR4int monocytes and exacerbated immune response within 24 h after the injury. These findings were reflected in the consistently elevated response to mitogen stimulation of the lymphocytes of patients with significant neurological remission. Early elevated concentrations of CD14-/CD16+/IL10+/CXCR4int monocytes were related to higher odds of CNS regeneration and enhanced neurological remission. The cluster dynamics of CD14-/CD16+/IL10+/CXCR4int monocytes in the early-acute phase after the injury revealed a maximum of prognostic information regarding neurological remission (mean parameter estimate: 0.207; selection count: 818/1000 repetitions). We conclude that early dynamics in monocyte subsets allow a good prediction of recovery from traumatic spinal cord injury.
2.
Laparoscopic surgery contributes more to nutritional and immunologic recovery than fast-track care in colorectal cancer.
Xu, D, Li, J, Song, Y, Zhou, J, Sun, F, Wang, J, Duan, Y, Hu, Y, Liu, Y, Wang, X, et al
World journal of surgical oncology. 2015;:18
Abstract
BACKGROUND Many clinical trials had repeatedly shown that fast-track perioperative care and laparoscopic surgery are both preferred in the treatment of colorectal cancer. But few studies were designed to explore the diverse biochemical impacts of the two counterparts on human immunologic and nutritional status. METHODS Ninety-two cases of colorectal cancer patients meeting the inclusion criteria were randomized to four groups: laparoscopy with fast-track treatment (LAFT); open surgery with fast-track treatment (OSFT); laparoscopy with conventional treatment (LAC); open surgery with conventional treatment (OSC). Peripheral blood tests including nutritional factors (albumin, prealbumin, and transferrin), humoral immunologic factors (IgG, IgM, and IgA), and cellular immunologic factors (T and NK cells) were evaluated. Blood samples were collected preoperatively (baseline) and 12 and 96 h after surgery (indicated as POH12 and POH96, respectively). RESULTS Albumin, transferrin, prealbumin, and IgG levels were the highest in the LAFT group for both POH12 and POH96 time intervals. Repeated measures (two-way ANOVA) indicated that the difference of albumin, transferrin, and IgG level were attributed to surgery type (P < 0.05) and not perioperative treatment (P > 0.05). Only in the laparoscopy-included groups, the relative albumin and IgG levels of POH96 were obviously higher than that of POH12. CONCLUSION Laparoscopic surgery accelerated postoperative nutrition and immune levels rising again while fast-track treatment retarded the drop of postoperative nutrition and immune levels. Laparoscopic surgery might play a more important role than fast-track treatment in the earlier postoperative recovery of nutritional and immunologic status. Combined laparoscopic surgery with fast-track treatment provided best postoperative recovery of nutrition and immune status. These results should be further compared with the clinical outcomes of our FTMDT trial (clinicaltrials.gov: NCT01080547).
3.
[Effect of Shenfu injection in postoperative recovery after abdominal surgery].
Zhou, Q, Liang, LJ, Zhang, L, Zhen, YY, Su, CK
Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica. 2007;(4):335-8
Abstract
OBJECTIVE To investigate the effect of Shenfu injection (SF) in postoperative recovery after abdominal surgery. METHOD 150 patients were randomly divided into control group (75) and SF group (75). The efficacy were evaluated with the time of passage of gas by anus, information of wound healing, blood routine, blood coagulaton function, liver function. Changes recovery factor, immune index and hemorheological index were detected too. RESULT The time of passage of gas by anus in SF group was significantly shorter than that in control group. Blood routine, blood coagulaton function, liver function showed no significant difference in the two group of preoperative and postoperative. Whole blood viscosity, blood reduced viscosity and plasma fibrinogen viscosity in SF group were significantly lower than that in control group after operation. IgG and IgA in SF group was significantly higher than that in control group after operation. IgG and CD4+/CD8+ in control group was significantly higher after operation than that in before operation. Among tissue damage plerosis correlation factor, the blood levels of superoxide dismutase (SOD) in SF group and control group is significantly lower than that in preoperation (P < 0.05), SOD in SF group was significantly higher than that in control group after operation. The blood levels of malondialdehyde (MDA) in SF group and control group is significantly higher than that in preoperation (P < 0.05). MDA in SF group was significantly lower than that in control group after operation. Whole blood viscosity, blood reduced viscosity and plasma fibrinogen viscosity in control group after operation were significantly higher than that before operation. CONCLUSION SF can stimulate the immune system and reduce the blood viscosity. It is contribute to the patients' rehabilitation.