IMPAIRMENT OF PHAGOCYTIC AND T-CELL-MEDIATED ANTIBACTERIAL ACTIVITY AND PLASMA ENDOTOXINS IN PATIENTS WITH UNTREATED GASTROINTESTINAL CANCER

Background: Cancer patients have multiple immune deficits, and mediato rs, such as prostaglandins, transforming,growth factor-beta, and inter leukin (ZL)-10, may play a role in the pathogenesis of these immune dy sfunctions. Methods: Fifty-six patients with gastrointestinal cancer ( 11 gastric cancer; 7 papilla of Vater cancer, and 38 colorectal cancer ) were enrolled for this study, before starting conventional treatment s. Phagocytosis and killing exerted by polymorphonuclear cells and mon ocytes, peripheral blood mononuclear cell absolute numbers, T-cell-med iated antibacterial activity, serum levels of IL-10 and interferon (IF N)-gamma, and plasma bacterial endotoxin concentration were evaluated. Results: Data show an impaired phagocytic and T-cell-mediated antibac terial activity in all cancer patients, whereas only in subjects with gastric cancer were IFN-gamma serum levels reduced. Circulating endoto xins were detected in 17 patients. Conclusions: In untreated gastroint estinal cancer patients the capacity of phagocytes and T-cells to clea r pathogens is reduced. This dysfunction may increase the risk of beco ming infected and may account for the presence of endotoxin in 30% of patients.