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Effects of hydrocortisone and adrenaline on natural killer cell activity
Authors:NOMOTO, Y.   KARASAWA, S.   UEHARA, K.
Affiliation:Department of Anaesthesiology, Kanto Rosai Hospital 2035 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki-city, Kanagawaken 211, Japan
Abstract:We have studied the effects of hydrocortisone and adrenalineon natural killer (NK) cell activity and on the distributionof circulating lymphocyte sub-populations in 30 patients undergoingelective partial laminectomy under general anaesthesia. Thepatients were allocated to receive adrenaline (group 1, n =11), hydrocortisone and adrenaline (group 2, n = 11) or neitherhydrocortisone nor adrenaline (group 3, n = 8). Group 1 andgroup 2 patients received local adrenaline infiltration duringoperation to reduce bleeding. The mean dose of adrenaline administeredwas 2.1 (SD 0.2) µg kg–1 Group 2 received hydrocortisone10 mg kg–1 i.v. after premedication. In groups 1 and 2,adrenaline produced an instantaneous increase in NK cell activityaccompanied by a selective increase in circulating NK cells.The measurements returned to pre-infiltration levels within120 min of administration of adrenaline. The effect of adrenalinein causing increased NK cell activity was not blocked by pre-administrationof hydrocortisone. There was a significant decrease in the ratioof T helper/inducer cells (CD4) to T-suppressor/ cytotoxic cells(CD8) in all patients after induction of anaesthesia. In groups1 and 3, the CD4/CD8 cell ratio did not change significantlyduring operation. However, compared with groups 1 and 3, group2 showed a significantly reduced CD4/CD8 cell ratio during operation.Therefore, these results suggest that even in cases of suchsevere stress that the immune response was depressed by increasedserum cortisol concentrations, adrenaline-induced NK cell activityenhancement was preserved.
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