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Enhanced spontaneous antibody response after coronary artery bypass surgery

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Abstract

Purpose

Cells spontaneously secreting immunoglobulins can be seen in the Wood one week after open-heart surgery. The purpose of this study was to measure the antibody specificities of activated cells.

Methods

Immune responses were studied preoperatively and on the seventh postoperative day in 18 patients undergoing elective coronary artery bypass surgery. The number of cells secreting adenovirns. measles, rubella and tetanus antigen specific antibodies spontaneously and induced by pokeweed mitogen PWM (ASCs) as well as the total number of cells secreting IgG. IgM and IgA (ISCs) were studied using an enzyme-linked immunospot (ELISPOT) assay. Spontaneous as well as phytohaemagglutinin (PUA)- and pokeweed mitogen (PWM)-induced lymphocyte proliferation was also measured.

Results

The number of cells spontaneously secreting IgG. IgM and IgA antibodies was increased on the seventh day after coronary bypass surgery, against adenovirus, measles, rubella and tetanus as well as the total number of cells secreting immunoglobulins IgG, IgM and IgA (P < 0.05/0.001). By contrast, only slight fluctuation was seen in the numbers of cells secreting antibodies after PWM stimulation. Spontaneous lymphocyte proliferation was also increased. PUA proliferative responses were depressed and PWM responses were not changed on the seventh postoperative day compared with preoperative values.

Conclusion

Coronary artery bypass surgery caused marked polyclonal B cell activation demonstrated by an increase of cells producing spontaneously antibodies against virus antigens and tetanus toxoid. This activation could not be intensified by PWM stimulation.

Résumé

Objectif

Une semaine après une chirurgie à coeur ouvert, on retrouve dans le sang des cellules qui sécrètent des immunoglobulines. Cette étude visait à mesurer la spécificité des anticorps propres aux cellules activées.

Méthodes

Les réponses immunitaires de 18 patients ont été étudiées avant une chirurgie de revasculansation myocardique non urgente et sept jours plus tard. Le nombre de cellules sécrétant spontanément des anticorps spécifiques aux adénovirus. à la rougeole, à la rubéole et au tétanos et les anticorps induits par le mitogème pokeweed PWM (ASC) ainsi que le nombre total des cellules sécrétant des IgG, IgM et IgA (ISC) ont été étudiées avec une épreuve d’immunospot lié aux enzymes (ELISPOT). En plus de la prolifération spontanée, la prolifération lymphocytaire induite par la phytohémagglutinine (PUA) et par le mitogène pokeweed a été mesurée.

Résultats

Le septième jour après l’intervention, on constatait une augmentation du nombre de cellules sécrétant spontanément des anticorps IgG, IgM et IgA contre les adénovirus. la rougeole, la rubéole et le tétanos aussi bien que du nombre de cellules sécrétant des immunoglobulines IgG, IgM et IgA (P < 0.05/001). Par contre, seulement de légères fluctuations ont été notées dans le nombre de cellules sécrétant des anticorps après la stimulation par le PWM. La prolifération lymphocytaire spontanée augmentait aussi, les réponses PHA prolifératnces étaient dépnmées et les réponses PWM ne changeaient pas la septième journée postopératoire comparativement aux valeurs préopératoires.

Conclusion

La chirurgie de revasculansation myocardique provoque une importante activation polyclonale des cellules B qui se manifeste par une augmentation des cellules produisant spontanément des anticorps contre les antigènes viraux et la toxoïde tétanique. Cette activation n’est pas intensifiée par la stimulation par le PWM.

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Author information

Correspondence to Matti Salo.

Additional information

Supported by grants from the Turku University Foundation and the Paulo Foundation.

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Salo, M., Mäkelä, M.J., Perttilä, J. et al. Enhanced spontaneous antibody response after coronary artery bypass surgery. Can J Anaesth 44, 617–622 (1997). https://doi.org/10.1007/BF03015445

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Keywords

  • Measle
  • Tetanus
  • Rubella
  • Coronary Artery Bypass Surgery
  • Rubella Virus