Abstract
Background
Toll-like receptors (TLR) that recognize microbial pathogens play a critical role
in innate immunity; however, their expression and function after surgery remain unknown.
The aim of this study was to examine TLR2 and TLR4 expression on monocytes and their
responses to each agonist after surgical insults.
Methods
Blood samples were obtained from 83 patients who underwent gastrointestinal surgery.
TLR2, TLR4, and inducible nitric oxide synthase expressions on peripheral blood mononuclear
cells (PBMCs) were analyzed by flow cytometry. Macrophage-activating lipopeptide-2
or lipopolysaccharide-induced tumor necrosis factor–α and interleukin-6 production
was measured by enzyme-linked immunosorbent assay.
Results
TLR2 and TLR4 decreased and showed the lowest values on the postoperative days 3 and
1, respectively. Macrophage-activating lipopeptide-2–stimulated tumor necrosis factor–α
and interleukin-6 production was decreased immediately after the operation (P<.05), increased to a maximum value on postoperative day 1, and then decreased gradually.
Lipopolysaccharide-stimulated tumor necrosis factor–α production was also suppressed
immediately (P<.05) after operation then showed a gradual increase to maximum values on postoperative
day 3. Inducible nitric oxide synthase in cultured PBMC that was obtained immediately
after operation was upregulated (P<.05).
Conclusion
Expressions of TLR2 and TLR4 were downregulated by operation, and agonist-induced
cytokine production was suppressed transiently and soon increased through the activation
of PBMC. The present study may offer new insights for postoperative modulation of
innate immunity under surgical stress.
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Article info
Publication history
Accepted:
August 8,
2003
Osaka, JapanFootnotes
☆Supported in part by grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
