Abstract
We describe herein the case of a 48-year-old man who underwent emergency massive resection of the small intestine due to strangulated ileus, which led to short bowel syndrome (SBS) as he was left with 7 cm of jejunum and 8 cm of ileum. We evaluated the immune function in this patient, focusing particular attention on T-cell-mediated immunity. Biochemical and nutritional parameters, including minerals and trace elements, indicated that the patient was in relatively good health; however, the proliferative response to mitogen and tumor necrosis factor-α production in response to the anti-CD3 monoclonal antibody in peripheral blood lymphocytes (PBL) were impaired compared with age-matched postgastrectomy patients and healthy donors. Moreover, the expression of T-cell receptor (TCR) ζ, which is involved in signal transduction and the subsequent activation of T cells, was downregulated in this patient compared with that in the age-matched postgastrectomy patients and healthy donors. These observations suggest that T-cell function was disturbed in our patient, and that this dysfunction was associated with the decreased expression of TCR ζ molecules.
Similar content being viewed by others
References
Vanderhoof JA, Langnes AN, Pinch LW, Thompson JS, Kaufman SS (1992) Short bowel syndrome (invited review). J Pediatr Gastroenterol Nutr 14:359–370
Warner BW, Chaet MS (1993) Nontransplant surgical options for management of the short bowel syndrome. J Pediatr Gastroenterol Nutr 17:1–12
Panis Y, Messing B, Rivet P, Coffin B, Hautefeuille P, Matsuchansky C, Rambaud JC, Valleur P (1997) Segmental reversal of the small bowel as an alternative to intestinal transplantation in patients with short bowel syndrome. Ann Surg 225:401–407
Wilmore DW, Lacey JM, Soultanakis RP, Bosch RL, Byrne TA (1997) Factors predicting a successful outcome after pharmacologic bowel compensation. Ann Surg 226:288–293
Kurkchubasche AG, Smith SD, Rowe MI (1992) Catheter sepsis in short bowel syndrome. Arch Surg 127:21–24
Kaufman SS, Loseke GA, Lupo JV, Young RJ, Murray ND, Pinch LW, Vanderhoof JA (1997) Influence of bacterial overgrowth and intestinal inflammation on duration of parenteral nutrition in children with short bowel syndrome J Pediatr 131:356–361
Kono K, Ressing ME, Brandt RMP, Melief CJM, Potkul RK, Andersson B, Petersson M, Kast WM, Kiessling R (1996) Decreased expression of signal transducing σ chains on peripheral T cell and NK cells in patients with cervical cancer Clin Cancer Res 2:1825–1828
Irving BA, Weiss A (1991) The cytoplasmic domain of the T cell receptor ζ chain is sufficient to couple to receptor-associated signal transduction pathways. Cell 64:891–901
Peretz A, Neve J, Duchateau J, Siderova, V, Huygen K, Famaey JP, Carpentier YA (1991) Effects of selenium supplementation on immune parameters in gut failure patients on home parenteral nutrition. Nutrition 7:215–221
Druart ML, Carpentier YA, Duchateau J, Huygen K, Famaey JP. (1985) Effect of surgery and nutritional support on some lymphocyte and PMN leukocyte functions in man. Clin Nutr 4:217–222
Gogos CA, Kalfarentzos FE, Zoumbos NC (1990) Effect of different types of total parenteral nutrition on T-lymphocyte subpopulations and NK cells Am J Clin Nutr 51:119–123
Kiessling R, Kono K, Petersson M, Wasserman K (1996) Immunosuppression in human tumor-host interaction: role of cytokines and alterations in signal transducing molecules. Springer Semin Immunopathol 18:227–242
Neve J, Vertongen F, Molle L (1985) Selenium deficiency. Clin Endocrinol Metab 14:629–636
Duchateau J, Delespesse G, Vereecke P (1981) Influence of oral zinc supplementation on the lymphocyte response to mitogens of normal subjects. Am J Clin Nutr 3:88–92
Zeitz M, Ullrich R, Schneider T, Schieferdecker HL, Riecken EO (1994) Cell differentiation and proliferation in the gastrointestinal tract with respect to the local immune system. Ann NY Acad Sci 733:75–86
Barrena MJ, Aldazabal EP, Cuadrado E, Bachiller P, Wang W, Tovar JA (1995) Lymphocyte subpopulations after extensive small bowel, resection in the rat. J Pediatr Surg 30:1447–1449.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kono, K., Sekikawa, T., Iizuka, H. et al. T-cell dysfunction in a patient with short bowel syndrome: Report of a case. Surg Today 29, 1253–1256 (1999). https://doi.org/10.1007/BF02482217
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482217