Original scientific paper
Immunological Status in Patients with Lower Limb Amputation Due to Peripheral Arterial Disease before and after Comprehensive Rehabilitation
Martin Štefančič
; University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
Metka Prešern-Štrukelj
; University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
Gaj Vidmar
; University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia and University of Ljubljana, Faculty of Medicine, Institute for Biostatistics and Medical Informatics, Ljubljana, Slovenia
Vladimir Kotnik
; University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
Andreja Nataša Kopitar
; University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
Alojz Ihan
; University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
Abstract
The immunological status before and after a comprehensive rehabilitation program was studied. Seven persons (4
males, 3 females, mean age 71.4 years) after lower limb amputation due to peripheral arterial disease (PAD) were subject
to standard comprehensive rehabilitation program for amputees of four-week duration, which included training in activities
of daily living, daily exercise of various types, training of crutch-assisted gait and use of leg prosthesis, and mild
transcutaneous electrical stimulation. Before and after rehabilitation, peripherial blood was collected and the number
and ratio of white blood cells were determined and analysed for the expression of cell surface antigens (CD3, CD4, CD8,
CD19, CD25, CD69), cytokines (IFN-gamma, IL-4) and phagocytosis/oxidative killing functional tests. Due to strict patient
selection criteria excluding serious accompanying disease, immunological parameters were within normal limits already
before rehabilitation. After rehabilitation, an increase in oxidative burst was observed in monocytes and neutrophil
granulocytes, but statistically signifi cant only in monocytes. The expression of CD69 molecules by T cells and monocytes
was signifi cantly increased, as well as the expression of IL-4 by T cells. A signifi cant decrease in the ratio of CD4 to CD8
cells was also found, but not a clinically critical one. It can therefore be concluded that the comprehensive rehabilitation
treatment in patients with lower limb amputation due to PAD led to some – prevailingly positive – immunological changes,
which were consistent with the patients’ improved physical condition and clinical status.
Keywords
physical therapy modalities; peripheral vascular disease; amputees; immune system processes
Hrčak ID:
147699
URI
Publication date:
30.3.2015.
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