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This Article Full Text Free Full Text (PDF) Free All Versions of this Article: 96/2/597    most recent 00090.2002v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by de Metz, J. Articles by Sauerwein, H. P. Search for Related Content PubMed PubMed Citation Articles by de Metz, J. Articles by Sauerwein, H. P.

Interferon- increases monocyte HLA-DR expression without effects on glucose and fat metabolism in postoperative patients

¹Department of Endocrinology and Metabolism, ⁶Department of Clinical Immunology and Rheumatology, and ⁷Renal Transplant Unit, Division of Internal Medicine, ⁸Clinical Immunology Laboratory, ³Laboratory of Endocrinology, Department of Clinical Chemistry, ⁴Department of Clinical Epidemiology and Biostatistics, ⁵Division of Surgery, Academic Medical Center, 1100 DD Amsterdam; and ²Department of Endocrinology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands

Submitted 4 February 2002 ; accepted in final form 29 May 2003

Tissue injury is associated with decreased cellular immunity and enhanced metabolism. Immunodepression is thought to be counteracted by interferon (IFN)-, which increases human leukocyte antigen (HLA)-DR expression. Hypermetabolism could be enhanced by IFN- because cytokines induce a hypermetabolic response to stress. In healthy humans, IFN- enhanced HLA-DR expression without effects on glucose and fat metabolism. In the present study, we evaluated whether IFN- lacks potential harmful side effects on metabolic and endocrine pathways while maintaining its beneficial effects on the immune system under conditions in which the inflammatory response system is activated. In 13 patients scheduled for major surgery, we studied HLA-DR expression on peripheral blood monocytes before surgery and postoperatively randomized the patients into an intervention and a placebo group. Subsequently, we evaluated the effects of a single dose of IFN- vs. saline on short-term monocyte activation, glucose and lipid metabolism, and glucose and lipid regulatory hormones. HLA-DR expression on monocytes was restored from postoperative levels of 54% (42-60%; median and interquartiles) to 92% (91-96%) 24 h after IFN- adminstration but stayed low in the placebo-treated patients. IFN- did not affect glucose metabolism (plasma glucose, rate of appearance and dissappearance of glucose) and lipid metabolism (plasma glycerol, plasma free fatty acids, and rates of appearance and disappearance of glycerol). IFN- had no effect on plasma cortisol, adrenocorticotropic hormone, growth hormone, insulin, C-peptide, glucagon, epinephrine, and norepinephrine concentrations. We conclude that IFN- exerts a favorable effect on cell-mediated immunity in patients after major surgery without effects on glucose and lipid metabolism.

hormones; stable isotopes; trauma; cytokines; human leukocyte antigen