Elevation of circulating interleukin 6 after surgery: factors influencing the serum level.
To investigate the effect of surgical trauma and other factors on the postoperative elevation of serum interleukin 6 (IL-6), we examined changes in IL-6 concentration after major thoracoabdominal surgery. Serum IL-6 levels reached the maximum concentration on the first postoperative day in all 38 patients, with peak ranging from 1400.8 +/- 383.4 pg/ml (mean +/- SEM) to 29.8 +/- 3.8 among six groups who underwent surgery at different sites. The IL-6 peak was significantly correlated with surgical trauma as defined by the operation length and the volume of blood loss during surgery (r = 0.554, P < 0.01 and r = 0.427, P < 0.01, respectively). The peak concentration of serum IL-6 in patients undergoing esophagectomy was significantly higher than in those undergoing pancreaticoduodenectomy (P < 0.05), despite a similar degree of surgical trauma defined by the operation length and volume of blood loss during surgery. Peak IL-6 concentration observed in a patient who underwent esophagectomy was about 100-fold greater in fluid drained from the thorax than in the peripheral blood. IL-6 mRNA was demonstrated in leukocytes from thoracic and abdominal exudate at 6, 24 and 48 h after surgery. In contrast, IL-6 mRNA could not be detected in leukocytes from the peripheral blood. Similar findings were also observed for interleukin 8 (IL-8). However, interleukin 1 beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha) were detected only once after surgery in the drainage fluid.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Surgery II, Kumamoto University School of Medicine, Japan.
K
K
Sakamoto
H
H
Arakawa
S
S
Mita
T
T
Ishiko
S
S
Ikei
H
H
Egami
S
S
Hisano
M
M
Ogawa
D000368:Aged; D015152:Blotting, Northern; D016207:Cytokines / Q000097:blood*; D017558:Elective Surgical Procedures; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000096:biosynthesis / Q000097:blood*; D016209:Interleukin-8 / Q000096:biosynthesis / Q000097:blood; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014947:Wounds and Injuries / Q000097:blood / Q000276:immunology
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha