Open Access Article from the journal “Current Metabolomics“
Abstract: Substantial immunoglobulin decreases followed minimally invasive and open surgery. Decreased IgG, IgM and IgE were detected 2 days after surgery, and IgG and IgM after 7 days. These changes were greater than haemodilution, reaching greater significance in open surgery patients. Immunoglobulin decreases followed lymphocyte decreases. In contrast, increased complement and inflammatory endothelial cell signals (C3 and C4, soluble TNFR-II) were detected 7 days after surgery. In both groups, increased C3 and TNFR-II followed early acute phase reactants CRP, IL-6 and ROS. Acute phase reactants and CD4/CD8 lymphocytes were factors most attenuated in patients undergoing minimally invasive thoracic surgery (VATS). This study suggests local trauma mediators are better biomarkers than circulating opsonins in defining the response to minimally invasive surgery, and a systems approach, comparing individual metabolic responses, is effective in small patient groups.