Pregled bibliografske jedinice broj: 412422
The proposed mechanism of action during different pain management techniques on expression of cytolytic molecule perforin in patients after colorectal cancer surgery
The proposed mechanism of action during different pain management techniques on expression of cytolytic molecule perforin in patients after colorectal cancer surgery // Medical hypotheses, 76 (2011), 3; 450-452 doi:10.1016/j.mehy.2010.11.019 (međunarodna recenzija, članak, znanstveni)
CROSBI ID: 412422 Za ispravke kontaktirajte CROSBI podršku putem web obrasca
Naslov
The proposed mechanism of action during different pain management techniques on expression of cytolytic molecule perforin in patients after colorectal cancer surgery
Autori
Golubović, Snježana ; Golubović, Vesna ; Sotošek Tokmadžić, Vlatka ; Šustić Alan ; Petković, Marija ; Bačić, Đordano ; Mrakovčić-Šutić, Ines
Izvornik
Medical hypotheses (0306-9877) 76
(2011), 3;
450-452
Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni
Ključne riječi
epidural analgesia; innate immunity; intravenous analgesia; perforin; colorectal cancer
Sažetak
The postoperative period is accompanied with neuroendocrine, metabolic and immune alteration which is caused by tissue damage, anesthesia, postoperative pain and psychological stress. Postoperative pain contributes to dysfunction of immune response as a result of interaction between central nervous and immune system. The postoperatively activated hypotalamo–pituitary–adrenocortical axis, sympathic and parasympathic nerve systems are important modulators of immune response. According to bidirectional communication of immune and nervous system, appropriate postoperative pain management could affect immune response in postoperative period. Although the postoperative suppression of immune response has been reported, a very little are known about the influences of different pain management techniques on cytotoxic function of immune cells in patients with colorectal cancer in early postoperative period. Perforin is a cytotoxic molecule expressed by activated lymphocytes which has a crucial role in elimination of tumor cells and virus-infected cells, mostly during the effector’s phase of immune response. Immune compromise during the postoperative period could affect the healing processes, incidence of postoperative infections and rate and size of tumor metastases disseminated during operation. The pharmacological management of postoperative pain in patients with malignancies uses very different analgesic techniques whose possible influence on cytotoxic functions of immune cells are still understood poor. For decades the most common way of treating postoperative pain after colorectal cancer surgery was intravenous analgesia with opiods. In the last decade many investigations pointed out that opiods can also contribute to postoperative suppression of immune response. Epidural analgesia is a regional anesthesia technique that acts directly on the origin of pain impulses and pain relief can be achieved with small doses of opiods combined with local anesthetics. Local anesthetics potentate analgesic properties of opiods but per se are also acting as antiinflammatory drugs. Afferent neural blockade by epidural analgesia attenuates neuroendocrine stress response. We propose that epidural analgesia could be more convenient that intravenous analgesia in maintenance of immunological homeostasis that is altered by surgical stress, tumor growth and pain.
Izvorni jezik
Engleski
Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti
POVEZANOST RADA
Projekti:
062-0000000-0220 - Perkutana traheostomija u prevenciji pneumonije u strojno ventiliranih bolesnika (Šustić, Alan, MZOS ) ( CroRIS)
062-0620096-0092 - Epiduralna analgezija i stanična imunost u bolesnika s kolorektalnim karcinomom (Golubović, Vesna, MZOS ) ( CroRIS)
062-0620096-0094 - Regulacijske T i NKT stanice u kontroli tumorskog rasta, opeklina i autoimunosti (Mrakovčić-Šutić, Ines, MZOS ) ( CroRIS)
Ustanove:
Medicinski fakultet, Rijeka,
Klinički bolnički centar Rijeka
Profili:
Snježana Golubović
(autor)
Marija Petković
(autor)
Ines Mrakovčić-Šutić
(autor)
Đordano Bačić
(autor)
Vesna Golubović
(autor)
Alan Šustić
(autor)
Vlatka Sotošek
(autor)
Citiraj ovu publikaciju:
Časopis indeksira:
- Current Contents Connect (CCC)
- Web of Science Core Collection (WoSCC)
- Science Citation Index Expanded (SCI-EXP)
- SCI-EXP, SSCI i/ili A&HCI
- Scopus
- MEDLINE