開心術におけるBリンパ球機能の変動

Abstract

The present study was attempted to elucidate the mechanism which account for modification of immunoglobulin synthesis following open heart surgery. Operations have been performed on 20 cases of coronary artery disease, 12 cases of acquired valvular disease and 4 cases of congenital heart disease using cardiopulmonary bypass (CPB). As an assessement of B lymphocyte function in vitro, protein A plaque method (Gronowicz) was employed ; numbers of IgM, IgG plaque forming cell (PFC) induced by staphylococcus aureus Cowan 1 (SAC) and pokeweed mitogen (PWM) decreased immediately after CPB and the decrease continued for as long as three days. Interleukin-2 (IL-2) production in mononuclear cell (MNC) was significantly suppressed after CPB, but Interleukin-1 production was not. The numbers of IgG PFC provoked exogenous IL-2 were attenuated following cardiac surgery in these patients. In conclusion, these results suggested that following CPB, suppression of IL-2 production in MNC and attenuated respense to exgenous IL-2 were correlated to the impairment of the B lymphocyte function. The clinical application of immunomodulators may be useful in making a defense against bacterial and viral infections resulting from the depression of antibody production after open heart surgery.