Einfluss von chirurgischem Trauma auf die Expression von Steroidhormonrezeptoren in PBMCs bei Patienten

Abstract

Background: Animal experiments demonstrate a gender-specific immune response following trauma and hemorrhagic shock. In this respect, male (immunosuppressive) and female (immunoprotective) sex hormones have been found to be responsible for this gender dimorphism. An increased expression of androgen and a decreased expression of estrogen receptors in male animals seem to potentiate the immunomodulatory effect of sex hormones. The effect of surgical trauma on the expression of steroid hormone receptors in PBMCs (peripher blood mononuclear cells) in patients, however, remains unknown. Objective: To investigate whether surgical trauma affects the expression of sex hormones in patients. Methods: Blood samples were obtained from 14 patients (7 males, 7 females) undergoing major abdominal surgery preoperatively and 2 hours postoperatively. Plasma was collected and PBMCs were isolated by Ficoll separation. The expression of the androgen receptor as well as the estrogen α- and β- receptors were determined by rt-PCR. β-Actin was used as house keeping gene. Results: The results indicate that surgical trauma has no influence on the expression of the androgen receptor and the estrogen receptors α and β in male patients. Similarly, in females the expression of sex hormone receptors in PBMCs was unaltered following abdominal surgical interventions. Discussion: The data demonstrate that in contrast to mice no alterations in the expression of androgen and estrogen hormone receptors in immune cells were evident following surgery in patients. This difference might be responsible for the observation that male and female sex hormones did not show immunomodulatory effects on PBMCs of surgical patients. Those findings suggest that immunomodulatory approaches using sex hormones or their receptor antagonists following surgery and blood loss in mice cannnot directly be transferred to the clinic arena.