Perioperative Period: Immunological Modifications

F. Cardinale, I. Chinellato, S. Caimmi, D. G. Peroni, F. Franceschini, M. Miraglia Del Giudice, R. Bernardini

Research output: Contribution to journalArticlepeer-review


Surgical stress induces complex modifications in the hemodynamic, metabolic, neuro-hormonal and immune response of the individual. The magnitude of these alterations depends on preoperative events leading to surgery, the severity of surgical trauma, and also on post-operative/post-traumatic complications ("multiple hit hypothesis"). As in other conditions of tissue damage, surgery trauma is followed by an immune-inflammatory response, initiated at the site of injury by the innate immune system, followed by a compensatory anti-inflammatory (or immunosuppressive) response (CARS), involving mainly cells of the adaptive immune system, which predispose the host to septic complications. The up-regulated inflammatory response, together with a profound impairment of macrophage and cell-mediated immunity, appear to be the cause for patients' increased susceptibility in developing subsequent sepsis after major surgery.

Original languageEnglish
Pages (from-to)3-12
Number of pages10
JournalInternational Journal of Immunopathology and Pharmacology
Publication statusPublished - Jul 1 2011


  • Compensatory anti-inflammatory (or immunosuppressive) response
  • Danger-associated molecular patterns
  • Surgery stress

ASJC Scopus subject areas

  • Pharmacology
  • Immunology
  • Immunology and Allergy


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