Relation between surgical injury and apoptosis of peripheral lymphocytes in infants

Objective To investigate the relationsh ip between operative stress and apoptosis of peripheral lymphocytes in infancy. Methods Twelve infants (8 boys and 4 girls) with choled ocele ( n =7) and congenital Hirschsprung's disease ( n =5) who underwent Ro ux-en-Y hepaticojejunostomy and Duhamel procedure respectively. The age ran ged from 6 months to 3 years. Six infants with severe sepsis were included in th is study. Six normal infants were served as control group. The early status of apoptosis was investigated using flow cytometric measurement of annexin-V/PI bi nding to the cell surface of peripheral lymphocytes. Fas expression of lymphocy tes before and after surgery were also studied. Results The percentage of apoptotic lymphocytes was incre ased in severe sepsis group ( 12.3 ± 2.0 %) and infants after major surge ry ( 14.1 ± 1.1 %) than that of the controls ( 5.1 ± 0.3 %, P 0. 05 ). No significant difference was found between severe sepsis and infants aft er major operation. As compared with the preoperative stage ( 36.3 ± 1.1 %) , Fas positive lymphocytes were increased at the end of surgery ( 50.3 ± 6.3 %) and 24 hours postoperatively ( 49.3 ± 4.3 %, P 0.05 ). Conclusion An early character of apoptosis of peripheral lymphocytes after operation may contribute to hypo-responsiveness of immune cel l in systemic inflammation in infants.