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|Title:||The effect of surgery on monocyte function.|
|Authors:||Neoptolemos, John P.|
|Abstract:||The effect of surgery and anaesthesia in relation to tumour spread and the development of sepsis is discussed and also in relation to the host's defence mechanisms. The structure and function of the monocyte-macrophage and its central role in natural and acquired immunity is elaborated. The methods of assessing monocyte function are critically evaluated and techniques of measuring migration, phagocytosis, chemi1uminescence and determining the whole blood monocyte count are described. Monocyte function was determined in normal subjects and before and after surgery in patients with benign disease and with colorectal cancer. Prior to surgery patients with colorectal tumours tended to have impaired monocyte migration, and increased phagocytosis, chemiluminescence and whole blood counts; serum from these patients also impaired migration both by an effect on the cells and on the chemotactic solution. Whereas surgery resulted in functional alterations considered to be beneficial in patients with benign disease, certain deleterious effects were found after surgery for malignancy: there was some further impairment of migration; serum further inhibited migration and reduced the capacity of a standard chemotactic solution; serum prevented the anticipated increase in chemiluminescence; finally total opsonic activity was decreased. Levamisole, an immunostimulating agent was administered prior to surgery with a view to enhancing monocyte migration, which is a fundamental property of the monocyte. Although encouraging results were seen in the pre-operative increase of migration from the poor migratory responses observed in some patients with tumours, the post-operative fall was not altered by levamisole. Other post-operative aspects of monocyte function were also unaffected by levamisole. The implications of these results are discussed in the context of previous findings on the effect of surgery on host immunity with particular reference to the fixed macrophages of the reticuloendothelial system.|
|Rights:||Copyright © the author. All rights reserved.|
|Appears in Collections:||Theses, College of Medicine, Biological Sciences and Psychology|
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