Ranitidine improves postoperative monocyte and neutrophil function
H. J. Nielsen, H. Nielsen, S. Jensen and F. Moesgaard
Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.
BACKGROUND: The histamine H2-receptor antagonist ranitidine hydrochloride
has been shown to improve trauma-, blood transfusion-, and sepsis-induced
immunosuppression. OBJECTIVE: To evaluate the effect of ranitidine on
postoperative impairment in monocyte and neutrophil function. METHODS:
Twenty-four patients undergoing major elective abdominal surgery were
randomized to receive adjuvant treatment with ranitidine hydrochloride (100
mg) administered twice a day intravenously from skin incision for 4 days,
followed by oral ranitidine hydrochloride (150 mg) administered twice a day
for 5 days (n = 11), or no adjuvant treatment (n = 13). Blood monocyte and
neutrophil chemotaxis and chemiluminescence were analyzed before the
operation and on postoperative days 1, 3, and 9. RESULTS: Monocyte
chemotaxis to C5a in the 13 control patients was significantly decreased on
day 1 compared with day 0. Chemotaxis in the 11 ranitidine-treated patients
increased significantly from day 0 to day 1 (P < .01 between groups).
Neutrophil chemiluminescence to zymosan and
N-f-methionyl-leucyl-phenylalanine was significantly increased in control
patients on day 1 compared with day 0 (P < .05), while ranitidine
reduced chemiluminescence to zymosan insignificantly on day 1 (P < .07
between groups). Five of the 13 control patients developed postoperative
infectious complications, which were related to decreased monocyte
chemotaxis to C5a and increased neutrophil chemiluminescence to zymosan,
compared with noninfected patients. A significant difference (P < .05)
in chemiluminescence to zymosan between infected and noninfected control
patients was observed on day 3 before clinical signs of infectious disease
could be detected. There were no infectious complications in
ranitidine-treated patients. CONCLUSION: These results support previous
studies on the effect of ranitidine to improve postoperative
immunosuppression.
