Effect of Anesthesia on Expression of Programmed Death-1 and Programmed Death-1 Ligand in Breast Cancer
- Conditions
- Programmed Cell Death 1
- Registration Number
- NCT04657237
- Lead Sponsor
- Assiut University
- Brief Summary
Surgery is first-line treatment for solid tumors. However, surgical trauma-induced physiologic stress has been demonstrated to facilitate metastasis and recurrence in different types of cancer. It has been reported that the PD-1/PD-L1 pathway could be activated by surgical stress. Hence, we instigate the effect of anesthetic technique on expression of PD1 and PD1 ligand.
- Detailed Description
The cellular immune response plays a central part in postoperative clearance of tumor cells. T lymphocytes and natural killer (NK) cells are two predominant cytotoxic effector cells that are the major components of antitumor immunity. In mouse models, proliferation of T lymphocytes in response to surgical trauma is defective . Programmed death-1 (PD-1) belongs to the CD28 receptor superfamily. It is an inhibitory receptor, and its expression is upregulated on activated leukocytes, resulting in an inhibited immune response. PD-1 interacts with two ligands: programmed death ligand-1 (PD-L1, also referred to as B7-H1) and programmed death ligand-2 (PD-L2, also known as B7-DC). PD-L2 is expressed mainly on activated dendritic cells (DCs) and macrophages, whereas PD-L1 is distributed widely. In addition to immune cells, some subsets of tumor cells also express PD-L1 to escape from immunosurveillance. It has been reported that the PD-1/PD-L1 pathway could be activated by surgical stress. Hence, we instigate the effect of anesthetic technique on expression of PD1 and PD1 ligand.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- Female
- Target Recruitment
- 20
- patients scheduled for breast cancer surgery
- compromised immune function (such as infection with the human immunodeficiency virus, immunodeficiency, or treatment with corticosteroids, immunosuppressive drugs, or chemotherapy)
- ASA > III
- age> 70 years old.
- patients refusal to the procedure.
- Infection of the skin at or near site of needle puncture.
- Coagulopathy .
- Drug hypersensitivity or allergy to the studied drugs.
- Central or peripheral neuropthy .
- Pre-operative opoid consumption ( within 24 hours preoperative )
- Anomalies of the vertebral column .
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method change in level of PD1 and PD1 ligand postoperatively preoerative (day-0),1st day, and 3 rd day after surgery blood sample will be withdrawn and human peripheral blood monocyte cells (PBMCs) will be separated with a Ficoll-Isopaque density gradient. Flow cytometric analyses will be carried out immediately. For ex vivo experiments, PBMCs will be cultured with Iscove's modified Dulbecco's medium (IMDM) containing 10 % human serum albumin.
- Secondary Outcome Measures
Name Time Method total request of analgesia 24 hours postoperative the total amount of analgesia (paracetamol) will be recorded and calculated
Related Research Topics
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Trial Locations
- Locations (1)
South Egypt Cancer Institute
🇪🇬Assiut, Egypt
South Egypt Cancer Institute🇪🇬Assiut, EgyptShereen M Kamal, LecturerContact01006279209sheridouh79@yahoo.comHassan M Kotb, ProfessorContactkotbhi@yahoo.com