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KMID : 0371319930440040479
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Journal of the Korean Surgical Society
1993 Volume.44 No. 4 p.479 ~ p.489
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Effect of Ranitidine on Postoperative Changes of T-Lymphocytes and Subsets, Delayed Hypersensitivity
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하우송
이영준/최진상/박순태/최상경/홍순찬/한호성
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Abstract
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Much recent evidence has accumulated to suggest that cell-mediated immunity is invariablely suppressed after major surgical procedures. As cell mediated immunity plays an important role in the host defense mechanism against microorganisms and
probably
also against the spread of tmor cells, much effort has been aimed at preventing this deleterious consequence of postoperative supression of cell-mediated immunity. Although the precise mechanism leading to postoperative immunosuppression is not
yet
known. Post-traumatic appearane of circulating histamine-induced suppressor facotr(HSF) described by Beer and Rocklin may be important.
HSF is thought to be produced by activated suppressor T-cell when 'stress'-released histamine binds to H₂-receptors expressed on the surface of the cell there by leading to downregulation of the immuneresponse.
In a randomized study of patients undergoing elective abdominal surgery. 12 received i.v. ranitidine(50 mg every 6 hous for 72 hours from the skin incision) and another 12 had no ranitidine treatment. Cell mediated immunity was assessed pre-and
postoperatively by skin test with seven common delayed type hypersensitivity(DTH) antigens and blood drawn 48 hours before and 72 hours after the skin incision was analyzed for the changes of T lymphocytes, its subsets by immunocytochemical
study.
Perioperative ranitidine diminished the expected postoperative reduction in DTH responses(p<0.05). There were no statistical significance in total postoperative T-lymphocyte(T₁), helper/inducer T-lymphocyte(T₄) and the ratio of T₄/T8
difference
between ranitidine and control group. Ranitidine group showed decreased levels of suppressor T-lymphocyte(T8) on 3 days after operation. There difference were statistically significant(p<0.05). The results may suggest potential benefit from
ranitidine
as regards postoperative infections complications and recurrence of malignancy.
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KEYWORD
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