Effect of surgery on neutrophil functions, superoxide and leukotriene production.

Perioperative changes of neutrophil function were investigated in 28 patients who underwent major surgery, particularly focusing on the potential capacity for superoxide and leukotriene production, which seem to be important in host defence. The superoxide-producing capacity of neutrophils, which was examined using N-formyl-peptide or phorbol myristate acetate as an attractant, significantly decreased postoperatively to 55 and 69 per cent of the pre-operative values, respectively. The leukotriene-producing capacity of neutrophils, which was stimulated with calcium ionophore A23187 in the presence of arachidonic acid, significantly changed postoperatively. The leukotriene B4 (LTB4) production increased together with an increment of production of 6-trans 6-trans LTB4, however, increased postoperatively to 1.2 times the (LTC4) production decreased postoperatively. The total production of leukotriene A4 (LTA4) metabolites consisting of LTB4, LTC4, and 6-trans LTB4, however, increased postoperatively to 1.2 times the pre-operative values. This indicates that neutrophils in the postoperative period have a higher capacity for LTA4 production but a lower capacity for superoxide production than those in the pre-operative period.