Interleukin-6 in transcatheter arterial embolization for patients with hepatocellular carcinoma. Effects of serine protease inhibitor.
BACKGROUND
Modulation of serum levels of circulating cytokines and inflammatory responses with a serine protease inhibitor was studied in 34 patients with hepatocellular carcinoma (HCC) after transcatheter arterial embolization (TAE).


METHODS
The 34 patients were randomly divided into two groups: 17 patients received 500 mg gabexate mesilate, a serine protease inhibitor, intravenously twice a day for 5 days after TAE, and the remaining 17 patients did not receive the drug.


RESULTS
In the patients not given the drug, circulating interleukin-6 (IL-6) markedly increased 1 day after TAE, reached a peak (approximately 8 times the pretreatment value) after 4 days, and remained elevated 7 days after TAE. In comparison, in the patients given the drug, circulating IL-6 was at a significantly lower level at 4 and 7 days after TAE (P < 0.05, respectively). Both groups did not show significant change in circulating interleukin-1 beta (IL-1 beta) and tumor necrosis factor alpha (TNF alpha) during the week after TAE. The drug also showed a tendency to keep patient temperature below 38 degrees C, and the elevation of serum C-reactive protein (CRP) concentration to less than 1 mg/dl after TAE (P < 0.05, respectively).


CONCLUSIONS
The serum level of circulating IL-6 can be modulated by serine protease inhibitor, and this may contribute to suppressing inflammatory responses, such as fever and acute-phase protein synthesis, in the liver after TAE.
Matsuda
Y
Y
Second Department of Internal Medicine, Osaka University Medical School, Japan.
Kawata
S
S
Nagase
T
T
Maeda
Y
Y
Yamasaki
E
E
Kiso
S
S
Ishiguro
H
H
Matsuzawa
Y
Y
D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005334:Fever / Q000209:etiology / Q000517:prevention & control; D016670:Gabexate / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007964:Leukocytosis / Q000209:etiology / Q000517:prevention & control; D008113:Liver Neoplasms / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013922:Thrombocytosis / Q000209:etiology / Q000517:prevention & control; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016670:Gabexate; D004317:Doxorubicin; D002097:C-Reactive Protein; D001219:Aspartate Aminotransferases; D002945:Cisplatin