title: Increase in lactoferrin and elastase alpha-1-proteinase inhibitor complexes but lack of complement activation and IL-6 response following thoracic surgery.
abstract: Polymorphonuclear neutrophil (PMN) stimulation and degranulation can be mediated by the cytokines and by complement activation. The aim of the present study was to measure TNF alpha, IL-1 alpha, IL-6 and C3d in relation to postoperative increase in lactoferrin and elastase alpha-1-proteinase inhibitor (E alpha-1-PI) levels. Eleven patients undergoing thoracic surgery took part in the study. Blood leucocytes, E alpha-1-PI, lactoferrin and C3d were measured preoperatively, at the end of surgery and postoperatively, at 4 h and on day 1, 2, 3 and 5. TNF alpha, IL-1 alpha and IL-6 were measured preoperatively, at the end of surgery and postoperatively, at 4 h, and on days 1 and 5. The leucocyte count, lactoferrin and E alpha-1-PI levels increased significantly postoperatively (P < 0.01). There was no significant change in C3d values. Plasma IL-6 levels were unchanged in the postoperative period. Plasma TNF alpha and IL-1 alpha were detectable at low levels in only two and four patients, respectively.
  
  
  CONCLUSIONS
  The postoperative increase in blood levels of PMN lactoferrin and E alpha-1-PI complexes observed in the present study was not accompanied by complement activation, or increased blood levels of IL-6.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Odense University Hospital, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Wanscher
authors.forename: E
authors.initials: E
authors.lastname: Tønnesen
authors.forename: S
authors.initials: S
authors.lastname: Antonsen
authors.forename: K
authors.initials: K
authors.lastname: Höhndorf
authors.forename: L K
authors.initials: LK
authors.lastname: Nielsen
authors.forename: G L
authors.initials: GL
authors.lastname: Hansen
mesh_terms: D000368:Aged; D015550:Cell Degranulation; D003167:Complement Activation; D015933:Complement C3d / Q000032:analysis; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007781:Lactoferrin / Q000097:blood*; D007958:Leukocyte Count; D019272:Leukocyte Elastase; D007962:Leukocytes / Q000473:pathology / Q000502:physiology; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000473:pathology / Q000502:physiology*; D010196:Pancreatic Elastase / Q000032:analysis*; D011013:Pneumonectomy; D013908:Thoracotomy; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D000515:alpha 1-Antitrypsin / Q000032:analysis*
chemical_list: D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000515:alpha 1-Antitrypsin; C037741:alpha 1-antitrypsin-leukocyte elastase complex; D015933:Complement C3d; D007781:Lactoferrin; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase