Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1979 Apr;189(4):475–479.

Nutritional Status and the Nonspecific Cellular and Humoral Immune Response in Esophageal Carcinoma

A A Haffejee, I B Angorn
PMCID: PMC1397270  PMID: 109056

Abstract

In carcinoma of the esophagus, two major factors are operative, both of which are capable of suppressing the immune response, namely starvation and the presence of a malignant tumor. Twenty patients who were treated by palliative intubation for unresectable carcinoma of the esophagus were investigated. All patients were suffering from protein-calorie malnutrition and were shown to be in negative nitrogen balance. Lymphocyte counts and the nonspecific cellular and humoral immune response were evaluated before and after correction of the nutritional deficit. No attempt was made to reduce tumor bulk. The cellular immune response was compromised in all patients. The DNCB skin test was negative, absolute lymphocyte counts and T-lymphocyte numbers were significantly depressed, and the mitogenic response to phytohaemagglutinin (PHA) stimulation also significantly depressed. Immunoglobulin A levels were significantly elevated but serum complement concentrations were normal. Reversal of the negative nitrogen balance resulted in a significant increase in absolute and T-lymphocyte numbers, and a significant increase in the mitogenic response to PHA. The DNCB skin test, however, remained nonreactive. Nutritional repletion also significantly increased serum C3, C4 and C3PA concentrations. Reversal of negative nitrogen balance may reverse in vitro evidence of immunoparesis and produce an increase in complement concentrations, without therapeutic reduction in the tumor load.

Full text

PDF
475

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AISENBERG A. C. Studies on delayed hypersensitivity in Hodgkin's disease. J Clin Invest. 1962 Nov;41:1964–1970. doi: 10.1172/JCI104654. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Chandra R. K. Rosette-forming T lymphocytes and cell-mediated immunity in malnutrition. Br Med J. 1974 Sep 7;3(5931):608–609. doi: 10.1136/bmj.3.5931.608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chretien P. B., Crowder W. L., Gertner H. R., Sample W. F., Catalona W. J. Correlation of preoperative lymphocyte reactivity with the clinical course of cancer patients. Surg Gynecol Obstet. 1973 Mar;136(3):380–384. [PubMed] [Google Scholar]
  4. Coovadia H. M., Parent M. A., Loening W. E., Wesley A., Burgess B., Hallett F., Brain P., Grace J., Naidoo J., Smythe P. M. An evaluation of factors associated with the depression of immunity in malnutrition and in measles. Am J Clin Nutr. 1974 Jun;27(6):665–669. doi: 10.1093/ajcn/27.6.665. [DOI] [PubMed] [Google Scholar]
  5. Copeland E. M., Fadyen B. V., Jr, Dudrick S. J. Effect of intravenous hyperalimentation on established delayed hypersensitivity in the cancer patient. Ann Surg. 1976 Jul;184(1):60–64. doi: 10.1097/00000658-197607000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Eccles S. A., Alexander P. Sequestration of macrophages in growing tumours and its effect on the immunological capacity of the host. Br J Cancer. 1974 Jul;30(1):42–49. doi: 10.1038/bjc.1974.111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Genco R. J., Taubman M. A. Secretory gamma-A antibodies induced by local immunization. Nature. 1969 Feb 15;221(5181):679–681. doi: 10.1038/221679a0. [DOI] [PubMed] [Google Scholar]
  8. Hersh E. M., Oppenheim J. J. Inhibition of in vitro lymphocyte transformation during chemotherapy in man. Cancer Res. 1967 Jan;27(1):98–105. [PubMed] [Google Scholar]
  9. Hughes N. R. Serum concentrations of G, A, and M immunoglobulins in patients with carcinoma, melanoma, and sarcoma. J Natl Cancer Inst. 1971 May;46(5):1015–1028. [PubMed] [Google Scholar]
  10. Law D. K., Dudrick S. J., Abdou N. I. Immunocompetence of patients with protein-calorie malnutrition. The effects of nutritional repletion. Ann Intern Med. 1973 Oct;79(4):545–550. doi: 10.7326/0003-4819-79-4-545. [DOI] [PubMed] [Google Scholar]
  11. Maness P. F., Orengo A. Serum complement levels in patients with digestive tract carcinomas and other neoplastic diseases. Oncology. 1977;34(2):87–89. doi: 10.1159/000225191. [DOI] [PubMed] [Google Scholar]
  12. Mekori T., Sher S., Robinson E. Suppression of the mitogenic response to phytohemagglutinin in malignant neoplasia: correlation with clinical stage and therapy. J Natl Cancer Inst. 1974 Jan;52(1):9–12. doi: 10.1093/jnci/52.1.9. [DOI] [PubMed] [Google Scholar]
  14. Parker J. W., Lukes R. J. A microculture method for lymphocyte transformation studies in the clinical laboratory. Am J Clin Pathol. 1971 Aug;56(2):174–180. doi: 10.1093/ajcp/56.2.174. [DOI] [PubMed] [Google Scholar]
  15. Riesco A. Five-year cancer cure: relation to total amount of peripheral lymphocytes and neutrophils. Cancer. 1970 Jan;25(1):135–140. doi: 10.1002/1097-0142(197001)25:1<135::aid-cncr2820250120>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  16. Roberts M. M., Bathgate E. M., Stevenson A. Serum immunoglobulin levels in patients with breast cancer. Cancer. 1975 Jul;36(1):221–224. doi: 10.1002/1097-0142(197507)36:1<221::aid-cncr2820360124>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  17. Rocklin R. E. Production of migration inhibitory factor by non-dividing lymphocytes. J Immunol. 1973 Mar;110(3):674–678. [PubMed] [Google Scholar]
  18. Southam C. M., Siegel A. H. Serum levels of second component of complement in cancer patients. J Immunol. 1966 Sep;97(3):331–337. [PubMed] [Google Scholar]
  19. Verhaegen H., De Cock W., De Cree J., Verbruggen F. Increase of serum complement levels in cancer patients with progressing tumors. Cancer. 1976 Oct;38(4):1608–1613. doi: 10.1002/1097-0142(197610)38:4<1608::aid-cncr2820380427>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  20. Watkins S. M. Cancer prognosis predicted by preoperative lymphocyte responsiveness in vitro. Br J Surg. 1976 Jun;63(6):433–434. doi: 10.1002/bjs.1800630605. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES