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- W2556712538 abstract "Purpose and Rationale of study: Previous investigators have been able to clearly describe how surgical trauma is associated with substantial alterations in the immune system (specifically towards suppression) and concomitant immune response. Such studies of immune function in this setting have outlined the type, number and operative status of the various immune cell subsets. In cancer patients, it would not be unrealistic to envisage how this state of relative immuno-suppression could create a tumor-permissive environment. One that could accelerate the growth of residual primary cancer cells and facilitate metastasis. Studies in humans have shown a laparotomy related decrease in the plasma levels of Insulin like Growth Factor binding protein 3 (IGFBP-3), a tumor inhibitor protein. This is believed to account in some part for the observed increased mitogenicity of postlaparotomy plasma when it was added to in-vitro cultures of the human colon cancer cell line HT-29 (1). Post-operative day 1 plasma was found to stimulate in vitro tumor growth to a significantly greater extent than preoperative plasma from the same patients. The duration and magnitude of this effect correlated directly with incision length (r = 0.58 and P< 0.01). The addition of exogenous IGFBP-3 to the POD1 plasma lowered the tumor cell proliferation rates to levels observed in the pre-operative plasma samples. Subsequently, the addition of IGFBP-3 antibody to preoperative plasma result in an increase in its tumor stimulatory effect parallel to that evident with post-operative day 1 plasma. Laparoscopic-assisted procedures were by and large associated with smaller decreases in plasma IGFBP-3 levels and more importantly no significant change in the in-vitro cancer stimulating capacity of post-operative plasma. It is believed that IGFBP-3 acts to contain tumor growth by directly inducing apoptosis and also by binding to and thus limiting the circulating levels of Insulin-like Growth factor 1 (IGF-1), a protein known to promote tumor growth. Other studies have corroborated the above observation, one such study in mice showed that full sham laparotomy when compared to carbon dioxide (CO2) insufflation, was associated with a higher rate of in-vivo tumor cell (C-26 colon adenocarcinoma) proliferation and a lower apoptotic rate on post-operative day 14 (2). Similar results were appreciated in other studies that compared open vs. closed bowel resection (3-5). The primary purpose of this study is to gather peri-operative plasma from patients undergoing major open and minimally invasive procedures with the aim of investigating and better understanding the effects of both surgical intervention types on postoperative immune function. Micro array analyses on circulating lymphocytes will be" @default.
- W2556712538 created "2016-11-30" @default.
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- W2556712538 date "2006-01-01" @default.
- W2556712538 modified "2023-09-24" @default.
- W2556712538 title "Study of the differential effects of minimally invasive and open colorectal resection on post-operative immune function by evaluating the circulating levels of plasma proteins and cytokines." @default.
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