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Open Access Research article

Laparotomy and laparoscopy diversely affect macrophage-associated antimicrobial activity in a murine model

Shun Gen Huang1, Yi Ping Li1, Qi Zhang1, H Paul Redmond2, Jiang Huai Wang2* and Jian Wang1*

Author Affiliations

1 Department of Pediatric Surgery, Affiliated Children’s Hospital, Soochow University, Suzhou, China

2 Department of Academic Surgery, University College Cork, Cork University Hospital, Cork, Ireland

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BMC Immunology 2013, 14:27  doi:10.1186/1471-2172-14-27

Published: 20 June 2013

Abstract

Background

Surgical intervention-related trauma contributes largely to the development of postoperative immunosuppression, with reduced resistance to secondary bacterial infection. This study compared the impact of laparotomy versus laparoscopy on macrophage-associated bactericidal ability and examined whether laparotomy renders the host more susceptible to microbial infection.

Results

BALB/c mice were randomized into control, laparotomy, and laparoscopy groups. Laparotomy, but not laparoscopy, significantly downregulated CR3 expression on macrophages, diminished macrophage-induced uptake and phagocytosis of E. coli and S. aureus, and impaired macrophage-mediated intracellular bacterial killing. Consistent with this, mice that underwent laparotomy displayed substantially higher bacterial counts in the blood and visceral organs as well as a significantly enhanced mortality rate following bacterial infection, whereas mice subjected to laparoscopy did not show any defects in their bacterial clearance.

Conclusion

Laparotomy has an adverse effect on host innate immunity against microbial infection by impairing macrophage-mediated phagocytosis and killing of the invaded bacteria. By contrast, laparoscopy appears to preserve macrophage-associated bactericidal ability, thus alleviating the development of postoperative immunosuppression.

Keywords:
Laparotomy; Laparoscopy; Phagocytosis; Bactericidal activity; Innate immunity; Macrophages