The fingerprints of the host innate immunity on the cells of primary virus-induced tumors

[Could anaesthesia, analgesia and sympathetic modulation affect neoplasic recurrence after surgery? A systematic review centred over the modulation of natural killer cells activity]

OBJECTIVE

The Natural Killer cells (NK) are an important part of non-specific cellular-mediated and antitumoral immunity. The goal of this review is to recapitulate data published over NK activity during the perioperative period and the influence of anaesthesia, analgesia and modulation of sympathetic system.

DATA SOURCES

Pubmed/Medline database.

STUDY SELECTION AND DATA EXTRACTION

Keywords-based selection, without limit of date: fundamental studies, randomized controlled trials and non-randomized comparative studies.

DATA SYNTHESIS

In human as in animal studies, an important correlation exists between NK activity and prognosis linked to the development of metastasis. The great depression of this cytotoxicity during the perioperative period could be able to compromise host defenses. The influence of anaesthetics and analgesics is important. The effects of the opioids, the agonists and the antagonists of the sympathetic nervous system, the prostaglandins, the NSAIDs, the ketamine, the hypnotics and the locoregional anaesthesia are systematically reviewed. The limits of experimental model presented are covered.

CONCLUSION

The effects of anaesthetic/analgesic drugs and techniques, the consequences of sympathomodulation on NK activity are numerous and sometimes opposite. It is important for the anaesthesiologist to keep in mind that the long term consequences of his techniques on the patients' outcome must be clarified.

Early phenotypic changes of in vitro transformed cells during in vivo progression: possible role of the host innate immunity

We described the earliest in vivo changes of in vitro transformed cells of various origin manifested in highly-increased H(2)O(2)-catabolizing and PGE(2)-releasing activities. We designate it as [H(2)O(2)(CA) + PGE(S)]-phenotype. It provided tumor cells with resistance to cytotoxicity of Mph and NK cells and correlated with increased tumorigenicity. Used as a functional marker of the early step of in vivo tumor progression [H(2)O(2)(CA) + PGE(S)]-phenotype allowed to estimate the difference in the rates of natural selection of tumor cells grown locally and/or disseminated and its significant delay related to bcl-2 gene expression. The data suggests that in vivo sublethal damage of tumor cells and activation of src gene are relevant to acquisition of [H(2)O(2)(CA) + PGE(S)]-phenotype.