title: Association between elevated plasma granulocyte colony-stimulating factor and the degree of surgical stress in patients undergoing gastrointestinal surgery.
abstract: To characterize the changes in perioperative plasma granulocyte colony-stimulating factor (G-CSF) and analyze the effect of surgical stress on its kinetics, 41 patients undergoing gastrointestinal surgery with varying degrees of surgical stress were examined. The plasma levels of G-CSF significantly increased immediately after the operation, probably in response to surgical injury. This elevation was much higher in the 15 esophagectomy patients, at 883 +/- 300 pg/ml on postoperative day (POD) O, than in the 14 gastrectomy patients, with a value of 233 +/- 151 on POD O, (P < 0.01) or in the 12 cholecystectomy patients, with a value of 64 +/- 41 on POD 1 (P < 0.01). These findings led us to conclude that G-CSF levels increase significantly in the immediate postoperative period and are most likely associated with the degree of surgical stress. In addition, we studied the priming effect of G-CSF on polymorphonuclear leukocytes (PMNs). G-CSF enhanced PMN superoxide anion (O2-) production and luminol-dependent chemiluminescence (CL) induced by opsonized zymosan in a dose-dependent manner. A significant enhancement was seen in the G-CSF level (1 ng/ml) which was almost the same as the maximum G-CSF level in the esophagectomy patients. Furthermore, postoperative PMN activation occurred after the elevation of plasma G-CSF. Thus, we propose that elevated G-CSF may act as one of the mediators which activate PMN function postoperatively.
authors.affiliation: Second Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yokota
authors.forename: T
authors.initials: T
authors.lastname: Nishihira
authors.forename: R
authors.initials: R
authors.lastname: Shineha
authors.forename: J
authors.initials: J
authors.lastname: Sayama
authors.forename: Y
authors.initials: Y
authors.lastname: Nitta
authors.forename: M
authors.initials: M
authors.lastname: Kimura
authors.forename: S
authors.initials: S
authors.lastname: Mori
mesh_terms: D000368:Aged; D002763:Cholecystectomy; D013505:Digestive System Surgical Procedures; D016629:Esophagectomy; D005260:Female; D005743:Gastrectomy; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D013312:Stress, Physiological / Q000503:physiopathology*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor