engleski

EFFECTS OF POST-OPERATIVE PAIN TREATMENT USING EPIDURAL OR INTRAVENOUS ANALGESIA ON INNATE AND AQUIRED IMMUNE RESPONSE

Background and aims: Identification of an immune response usually correlate for protection against diifferent types of postsurgical complications, depending also of postoperative pain management techniques. However, finding such a correlate has been a daunting task.The efficacy of tumor cell-immune cell interactions depends on a number of factors, for example the type of immune cell, the expression of cytolitic molecules, the ability of tumor cells for immune cells and the expression of immunogenic epitopes. Numerous studies over the past decade have demonstrated the importance of innate immune response [NK, NKT cells, naturally occurring CD4+ CD25+ Foxp3+ regulatory T cells (nTregs)] in immune regulation during autoiimune diseases, tumor growth, transplant reactions, as well as in allergic disorders. Methods:This study evaluates the expression of cytolitic molecule perforin in peripheral blood lymphocytes of colon carcinoma patients followinh epidural analgesia or intravenous-Tramadol analgesia.and correlate this values with the number of NK, NKT cells, regulatory T cells (Tregs), as well as with the number of T cells (CD3+, CD4+, CD8+ cells) and CD19+ (marker of B lymphocytes) Results: Our preliminary data clearly demonstrate that cytolitic potential of peripheral blood lymphocytes from colon carcinoma patients, measuring by expression of perforin, depend of different postoperative pain management techniques and have showened signifficantly increased values of perforin after epidural analgesia. Conclusions: These data suggest that perforin cytolitic pathway positively correlates with the number of innate immune response cells (Tregs and NKT cells), showing that epidural analgesia induced less changes in innate immune response than the intravenous one. Acknowledgment: This work was supported by grants from the Croatian Ministry of Science (projects: 0620096-0092 and 0620096-0094)

epidural analgesia; innate immunity; intravenous analgesia; postoperative pain

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