Regulatory T cells in the blood: a new marker of surgical stress.

PURPOSE: The function of regulatory T cells (Foxp3(+)CD4(+)CD25(+) T cells: Treg) after surgery remains unspecified. We investigated the potential role of Treg as a new stress marker for various operations.

METHODS

Thirty-three patients who underwent various operations at our department were divided into the following three groups based on the invasiveness of their surgery: Group A, those who underwent massively invasive surgery; Group B, those who underwent moderately invasive surgery; and Group C, those who underwent minimally invasive surgery. We measured Treg levels in the peripheral blood by flow cytometry and labeling with anti-CD4, CD25, and Foxp3 antibodies on preoperative day 1 and then on postoperative days (PODs) 1 and 6. Treg subpopulations in each group on the 3 days were compared.

RESULTS

Treg subpopulations were significantly higher on POD 6 than on preoperative day 1 in all patients. In Group B, Treg subpopulations varied according to the operative procedures undertaken. For example, there were marked differences between open and laparoscopic abdominal surgery. In Group A, the Treg subpopulations tended to be increased on POD 6, although those on POD 1 were lower than those on preoperative day 1.

CONCLUSIONS

These findings suggest that Treg is an efficient biomarker, indicative of the degree of surgical stress and its impact on immunological status.