2009 4 81~ 84 Journal of Kunming Medical University CN 53-1049/ R 1 6- Th 650118 1 6- F- 16-2P 60 36~69 ASA C NSn =30 F FDP n=30c NS4 ml/kgf 1 6-250 mg/kg 5 3 ml IFN-γ TNF- α IL- 2 IL- 4 IL-5 IL- 10 Th1/ Th2 P<001 P>005 Th2 IL-10 P<001 Th1 P <001 Th1/ Th2 P<001 P<001 5 1 6- Th1 Th1/ Th2 Th1 16- Q532 + 3R7379 A 1003-4706 200904-0081-05 Effect of Fruct ose- 16- bisphosphat e on Th1 and Th2 Cell Polarizat ion in Pat ient s Undergoing Breast Cancer Surgery WANG Zhong-huiDAI Dong-meiBIAN LinZHAO Guang-yuJIN Cong-guoZHANG Ji Dept of AnesthesiologyThe 3rd Affiliated Hospital of Kunming Medical UniversityKunming Yunnan 650118China AbstractObjective To investigate the influence of fructose- 16- bisphosphate on Th1 and Th2 cell polarization in patients undergoing breast cancer surgerymethods Sixty ASAorpatients aged 36-69 yr undergoing breast cancer surgery were randomly assigned to one of 2 groups ( n=30 each) : The control group(c) and fructose- 16- bisphosphate group(f)patients in F group received fructose- 16- bisphosphate 250 mg/kg intravenously 15 min before anesthesia inductionanesthesia was induced with midazolamfentanyletodamate and vecuronium and maintained with propofol and remifentanyl infusion and intermittent IV boluses of vecuronium in both groupsblood samples were taken before intravenous fructose- 16- bisphosphate after the end of operation and the fifth day after surgery for determination of serum levels of IFN- γtnf- αil- 2IL- 4 IL- 5 and IL- 10 and serum levels of Th1Th2 cell and Th1/Th2 ratioresults Before intravenous fructose- 1 6- bisphosphatethe serum levels of cytokine- dependent Th1 and Th2 were higher than normal in two groups 02QY141 1968~ E- mail:leedyy@126com
82 30 P<001 There was no significant difference between the two groupscytokine- dependent Th2 increased significantly after the end of operation as compared with the baseline before intravenous fructose- 1 6- bisphosphate in the control group (P<001) Cytokine- dependent Th1 increased singnificantly after the end of operation as compared with the baseline before intravenous fructose- 16- bisphosphaten in the fructose- 1 6- bisphosphaten grupe The Th1/Th2 ratio decreased in the control group while the Th1/Th2 ratio increased in the fructose- 16- bisphosphatenand there was significant difference between the two groups P<001) The levels of cytokine recovered to the baseline before operation at the fifth day after operation in the two groups Conclusions There is imbalance of cytokine- dependent Th1 and Th2 cell before operationand the Th1/Th2 balance moves toward the Th2 directionthe FDP can increase the level of cytokine- dependent Th1and improve cell immunity function Key wordsfructose- 16- bisphosphatebreast cancercytokineth1/th2 cell polarization 15 min 1 6 - F- 1 006 ~008 mg/kg 02 mg/kg 6-2PFDP Th2 4~5 μg/kg 08 mg/kg [8] 1 6-10 /min Th1 Th2 8~10 ml/kg : 1:15 100% 35~40 mmhg(1 kpa=75 1 6- mmhg) 4~8 mg/(kgh) Th1 Th2 Th1 Th2 0125~02 μg/(kgmin) 1 6-01 mg/kg 10~12 ml/(kgh) 6% 130/04 1:1 1 11 IFN-γ TNF- α IL- 2 Th2 IL- 4 IL-5 IL- 10 Th1 Th2 TNM 60 CBA 36~69 45~65 kg ASA C NS 12 n=30 F FDPn=30 5 3 ml Th1 SPSS 30 min 006 mg/kg ± x±s 001 mg/kg t ECG HR SpO 2 P<005 BP A6B1322Baxter 4 ml/kg 2 1 6-20060405 250 mg/kg ASA
4 1 6- Th 83 TNM IL-4 IL-5 IL-10 P>005 1 Th1 005 IL-4 IL-5 IL- 2 TNF- α IFN- γ P>005 IL-10 C P <001 P> F P<001 5 005 C IL-2 IFN-γ P>005 TNF- α F IL-2 IFN-γ TNF- α P< 001 IL-2 IFN-γ Th1/ Th2 P < P<001 5 001 5 Th1/ Th2 2 P<001P> 3 Th1/ Th2 Th2 C Th1/ Th2 F Th1/ Th2 4 C F n=30 1 x±s Tab 1 Charact erist ics of t he pat ient s x±s kg h 46±10 55±10 25±03 14 16 49±10 52±10 25±03 12 18 2 Th1 pg/ml x±s Tab 2 Changes in cyt okine- dependent Th1 in group C and F pg/ml x±s 5 IL- 2 C 2593±1506 ** 2495±1129 2389±1195 259±101 F 2140±1077 ** 2683±743 # 2328±1140 TNF- α C 2169±914 ** 2240±809 2274±681 1064±100 F 1844±706 ** 2099±753 1820±813 IFN-γ C 4265±2682 ** 3552±2204 4135±2189 1206±519 F 5180±2422 ** 6453±2691 # 5029±2404 ** P <001 # P <005 n=30 3 Th2 pg/ml x±s Tab 3 Changes in cyt okine- dependent Th2 in group C and F pg/ml x±s 5 IL- 4 C 1887±617 ** 2102±684 2119±722 242±053 F 1752±853 ** 1679±594 1813±893 IL- 5 C 1756±921 ** 1603±720 1958±843 176±044 F 1189±532 ** 1359±512 1292±548 IL- 10 C 1754±944 ** 2078±812 # 1814±950 369±116 F 1803±835 ** 1992±777 1941±965 ** P<001 # P<005 n=30
84 30 5 Th1 C 9027±4638 8287±3673 8797±3765 F 9264±3345 11135±3702 9245±3131 Th2 C 5397±1894 5782±1944 5891±1894 F 4855±1949 5030±1687 5157±2144 Th1/Th2 C 173±076 148±045 157±060 F 194±045 225±040 * 187±057 * P <005 n=30 3 4 Th1/Th2 pg/ml x±s Tab 4 Changes in t he Th1/Th2 rat io in group C and F pg/ml x±s Th1 Th1 IFN-γ Th2 Th1/ Th2-2 IL- 2 TNF- α Th1/ Th2 Th1 TNF- α Th2-4 IL- 4-5 IL- 5-10 IL- 10 Ig IgG IgE TNF- α IgA Th TNF- α Th1 1 6- IL- 2 IFN-γTh2 IL- 4 [8] Th1 IFN-γ IL- 2 Th2 IL- 4 IL- 10Th1 TNF- α Th2 IL-10 Th2 Th1/ Th2 Th2 1 6- Th1 Th1/Th2 1 6- Th1 [1] Th1/ Th2 Th1/ Th2 Th1/ Th2 Th2 [2] Th1/ Th2 1 6-1NALDINI A PUCCI A BERNINI C et alregulation of [3] angiogenesis by Th1- and Th2- type cytokinesjcurr 1 6- Pharm Des 2003 9 511-519 2 Th1/ Th2 [4,5] J 2006 18 304-306 3 1 6- J [6,7] Th2 2005 17 87-88 [8] 4BORDIGNON NUNES F MEIER GRAZIOTTIN C A L - 1 6- Th1 IL-2 IFN-γ Th2 IL- 4 IL- 10 1 6-103
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