|Table of Contents|

Effect of ulinastatin on CD14+alveolar macrophage and immune function in patients with esophageal cancer surgery

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 09
Page:
1701-1706
Research Field:
Publishing date:

Info

Title:
Effect of ulinastatin on CD14+alveolar macrophage and immune function in patients with esophageal cancer surgery
Author(s):
FU Xiaoyu1; JIN Guangshan1; HE Jianhua1; 2; CAO Junli3
1.School of Anesthesiology,Xuzhou Medical University，Jiangsu Xuzhou 221004,China;2.Department of Anesthesiology,the Affiliated Cancer Hospital of Nanjing Medical University,Jiangsu Nanjing 210009,China;3.Jiangsu Province Key Laboratory of Anesthesiology,Xuzhou Medical University,Jiangsu Xuzhou 221004,China.
Keywords:
CD14+macrophage; one-lung ventilation; ulinastatin; inflammatory reaction; immune reaction
PACS:
R735.1
DOI:
10.3969/j.issn.1672-4992.2023.09.022
Abstract:
Objective：To investigate the effect of intravenous ulinastatin on CD14+alveolar macrophages,local and systemic inflammatory response,and immune function during one-lung ventilation in patients undergoing esophageal cancer surgery.Methods：Eighty patients who underwent thoracoscopic radical resection surgery of esophageal cancer were prospectively selected from October 2019 to August 2020 in the Affiliated Cancer Hospital of Nanjing Medical University.They were randomly divided into two groups using a digital random table method:The control group and the ulinastatin group,with 40 patients each.Before anesthesia induction,patients in the ulinastatin group received an intravenous infusion of 20 KU ulinastatin,while patients in the control group were given normal saline.Interleukin-2 (IL-2) and immune cells were detected in peripheral venous blood before operation and at 2 h after the operation,and CD14+macrophages,IL-2,and immune cells were detected in bronchoalveolar lavage fluid (BALF) on the non-ventilated side of the lung after one-lung ventilation about 1 h during operation.Results：There were no differences in general condition between the two groups.The increase of IL-2 and CD14+monocytes in the peripheral blood of patients in the ulinastatin group after the operation about 2 h was less than that of the control group (P＜0.05),and the increase of NK cells,CD4+T cells,CD8+T cells and activated T cell subsets was higher than that of the control group (P＜0.05).There was no difference between the two groups in peripheral blood IL-2,CD14+monocytes,and significant immune cell subsets before operation (P>0.05).Compared with the control group,the increase of IL-2 and CD14+macrophages in the lung BALF on the non-ventilated side of patients in the ulinastatin group was significantly lower than that in the control group (P＜0.05) after one-lung ventilation about 1 h.At the same time,CD4+T cells and CD8+T cells were higher than those in the control group (P＜0.05),and activated T cells were also higher than those in the control group (P＜0.01).Conclusion：The administration of ulinastatin before anesthesia can reduce the local and systemic inflammatory reaction,and protect the immune function of patients in one-lung ventilation during esophageal cancer surgery,which has clinical application value.

References:

［1］ MASAYUKI WATANABE,REIKO OTAKE,RYOTARO KOZUKI,et al.Recent progress in multidisciplinary treatment for patients with esophageal cancer［J］.Surg Today,2020,50(1):12-20.
［2］ KIKUCHI H,TAKEUCHI H.Future perspectives of surgery for esophageal cancer［J］.Ann Thorac Cardiovasc Surg,2018,24(5):219-222.
［3］蔡华新,黄灿华,杨春萍,等.胸腹腔镜联合手术对食管癌患者炎症及创伤应激的影响［J］.癌症进展，2021,19(20):2091-2094. CAI HX,HUANG CH,YANG CP,et al.Effect of thoraco-laparoscopic surgery on inflammation and traumatic stress in patients with esophageal cancer［J］.Oncology Progress,2021,19(20):2091-2094.
［4］杏福宝，张雷，唐震，等.胸腹腔镜食管癌根治术对患者术后免疫功能的影响［J］.南方医科大学学报，2021,41(1):146-150. XING FB,ZHANG L,TANG Z,et al.Effect of thoraco-laparoscopic esophagectomy on postoperative immune function of patients with esophageal carcinoma［J］.Journal of Southern Medical University,2021,41(1):146-150.
［5］ HE S,XU J,LIU X,et al.Advances and challenges in the treatment of esophageal cancer［J］.Acta Pharm Sin B,2021,11(11):3379-3392.
［6］ CIESIELSKA A,MATYJEK M,KWIATKOWSKA K.TLR4 and CD14 trafficking and its influence on LPS-induced pro-inflammatory signaling［J］.Cell Mol Life Sci,2021,78(4):1233-1261.
［7］ 金肇权，张文彬，陈欣，等.CD14-TLR4-NF-κB信号传导通路在脂多糖诱导ALI/ARDS中的作用及机制研究［J］.安徽医药，2022,26(04):643-647. JIN ZQ,ZHANG WB,CHEN X,et al.Role and mechanism of CD14-TLR4-NF-κB signaling pathway in LPS induced ALI/ARDS［J］.Anhui Medical and Pharmaceutical Journal,2022,26(04):643-647.
［8］LYU B,JIANG XM,WANG DW,et al.Protective effects and mechanisms of action of ulinastatin against cerebral ischemia-reperfusion injury［J］.Curr Pharm Des,2020,26(27):3332-3340.
［9］李霞，庄伟，马冲，等.丙氨酰谷氨酰胺辅助乌司他丁治疗重症急性胰腺炎肺损伤的效果及对肺功能,炎症反应,免疫功能的影响［J］.中国医药导报,2022,19(7):92-95. LI X,ZHUANG W,MA C,et al.Effect of Alanyl Glutamine-assisted Ulinastatin in the treatment of severe acute pancreatitis lung injury and the influence on lung function,inflam-mation,and immune function［J］.China Medical Herald,2022,19(7):92-95.
［10］ 赵丽，王胜.乌司他丁脏器保护机制的研究进展［J］.中华重症医学电子杂志(网络版)，2019,5(03):274-277. ZHAO L,WANG S.Research progress on mechanisms of organ protection by Ulinastatin［J］.Chinese Journal of Critical Care and Intensive Care Medicine(Electronic Edition),2019,5(03):274-277.
［11］ WANG KY,YANG QY,TANG P,et al.Effects of ulinastatin on early postoperative cognitive function after one-lung ventilation surgery in elderly patients receiving neoadjuvant chemotherapy［J］.Metab Brain Dis,2017,32(2):427-435.
［12］ REN KW,SHEN N,TANG JL,et al.Effects of ulinastatin on inflammatory response and cognitive function after hip arthroplasty for the elderly patients with femoral neck fracture［J］.Eur Rev Med Pharmacol Sci,2018,22(4):1126-1132.
［13］ HUANG N,WANG F,WANG Y,et al.Ulinastatin improves survival of septic mice by suppressing inflammatory response and lymphocyte apoptosis［J］.J Surg Res,2013,182(2):296-302.
［14］ ZHOU L,LAN H,ZHOU Q,et al.Continuous infusion of high-dose ulinastatin during surgery does not improve early postoperative clinical outcomes in patients undergoing radical lung cancer surgery:A pilot study［J］.Thorac Cancer,2016,7(5):581-587.
［15］ CONG X,HUANG Z,ZHANG L,et al.Effect of different anaesthesia methods on perioperative cellular immune function and long-term outcome in patients undergoing radical resection of esophageal cancer:a prospective cohort study［J］.Am J Transl Res,2021,13(10):11427-11438.
［16］ 董桂祥.静脉全麻复合硬膜外麻醉及自控硬膜外镇痛对食管癌患者术后T细胞亚群和循环与呼吸的影响［J］.临床和实验医学杂志，2014,13(8):639-642. DONG GX.Study on affect of intravenous anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia on T cell subsets,circulation and respiration in patients with esophagus cancer after surgery［J］.Journal of Clinical and Experimental Medicine,2014,13(8):639-642.
［17］ 中华医学会呼吸病学分会呼吸危重症医学学组,中国医师协会呼吸医师分会危重症医学工作委员会.ICU患者支气管肺泡灌洗液采集、送检、检测及结果解读规范［J］.中华结核和呼吸杂志，2020,43(09):744-756. Respiratory Critical Care Medicine Group,Respiratory Disease Branch of Chinese Medical Association,Critical Care Medicine Working Committee of Respiratory Physician Branch of Chinese Medical Doctor Association.Standardized for bronchoalveolar lavage fluid collection,testing,detection and interpretation of results in ICU patients［J］.Chinese Journal of Tuberculosis and Respiratory Diseases,2020,43(09):744-756.
［18］ QIU J,XIAO X,GAO X,et al.Ulinastatin protects against sepsis-induced myocardial injury by inhibiting NLRP3 inflammasome activation［J］.Mol Med Rep,2021,24(4):730.
［19］ LI J,HU C,YANG H,et al.Effects of ulinastatin on immune function of patients with severe burn injury［J］.Chinese Journal of Burns,2016,32(6):345-350.
［20］ 郑玉春,李伟霞.乌司他丁对COPD患者肺功能及外周血Th17和Th22细胞水平的影响［J］.黑龙江医药科学，2021,44(06):156-157. ZHENG YC,LI WX.Effects of ulinastatin on lung function and peripheral blood Th17 and Th22 cell levels in COPD patients［J］.Heilongjiang Medicine and Pharmacy,2021,44(06):156-157.
［21］ SUGASAWA Y,YAMAGUCHI K,KUMAKURA S,et al.The effect of one-lung ventilation upon pulmonary inflammatory responses during lung resection［J］.J Anesth,2011,25(2):170-177.
［22］ 陶广华，吴勇，张文龙,等.乌司他丁联合右美托咪定对单肺通气肺叶切除肺癌患者血清免疫指标影响［J］.现代中西医结合杂志，2022,31(13):1775-1780. TAO GH,WU Y,ZHANG WL,et al.Effects of ulinastatin combined with dexmedetomidine on serum immune indexes in patients with lung cancer undergoing one-lung ventilation lobectomy［J］.Modern Journal of Integrated Traditional Chinese and Western Medicine,2022,31(13):1775-1780.
［23］ 霍苗，张倩，杨光，等.乌司他丁联合右美托咪定对感染性休克大鼠的抗炎作用［J］.武汉大学学报(医学版)，2022,43(3):366-369,375. HUO M,ZHANG Q,YANG G,et al.Anti-inflammation effect of ulinastatin combined with dexmedetomidine in septic shock rats［J］.Medical Journal of Wuhan University,2022,43(3):366-369,375.
［24］ ZHENYU H,QIAOLI Y,GUANGXIANG C,et al.The effect of Ulinastatin on postoperative course in cardiopulmonary bypass patients in Asia:a meta-analysis of randomized controlled trials［J］.J Cardiothorac Surg,2022,17(1):66.
［25］ DUAN M,LIU F,FU H,et al.Effect of ulinastatin on early postoperative cognitive dysfunction in elderly patients undergoing surgery:A systemic review and Meta-analysis［J］.Front Neurosci,2021,15:618589.
［26］龙灿，李成.基于CCL3/CCR1轴分析乌司他丁对食管癌患者放射性肺损伤的保护作用［J］.标记免疫分析与临床，2021,28(3):435-440. LONG C,LI C.The protective effect of ulinastatin on radiation-induced pulmonary injury based on ' CCL3/CCR1' axis in patients with esophageal carcinoma［J］.Labeled Immunoassays and Clinical Medicine,2021,28(3):435-440.

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江苏省六大人才高峰项目（编号：2016-wsw-019）
Last Update: 2023-03-30