engleski

POSTOPERATIVE PAIN MANAGEMENT TECHIQUES INFLUENCE ON THE EXPRESSION OF CYTOLITIC MOLECULE PERFORIN

Background and aims: One of the common and very often, as well as the most difficult symptom in oncology patients is varying degrees of pain and this pain may cause the changes in immunological parameters of these patients. The pharmacological management of postoperative pain in patients with malignancies uses very different techniques whose possible cytotoxic features we still poorly understood. The present study compared two postoperative pain management techniques in patients undergoing colorectal carcinoma surgery: intravenous analgesia and patient-controlled epidural analgesia (PCEA), on expression of cytolitic molecule perforin in peripheral blood mononuclear cells of these patients. Methods: Venous blood samples were taken from colon carcinoma patients and also from healthy volunteers and peripheral blood leukocytes (PBL) were isolated. Phenotype of lymphocytes and perforin expression were analyzed using intracellular and surface immunofluoresecncy and flow cytometric analysis (FACSCalibur). Results: Our results demonstrated that 20-30% of PBL in all examine group are perforin positive (total perforin is significantly higher than in control group, but in patient underwent epidural analgesia these expression was higher than in intravenous experimental group). Conclusions: These preliminary data suggest that human perforin is differentially expressed in distinct sub-populations of peripheral blood lymphocytes of patients with colorectal carcinoma, implicating the important role of postoperative pain management techniques on expression of perforin positive cells and their role in naï ; ve immune response and cytotoxic activity of peripheral blood lymphocytes. Acknowledgment: This work was supported by grants from the Croatian Ministry of Science (projects: 0620096-0094 and 0620096-0092)

colorectal carcinoma; innate immunity; postoperative pain;

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