title: Relationship between circulating secretory immunoglobulin A levels and portal blood cytokine levels during major abdominal surgery.
abstract: OBJECTIVE
  To investigate whether circulating secretory immunoglobulin A (S-IgA) levels correlate with cytokine and endotoxin levels in the systemic or portal circulation during major abdominal surgery.
  
  
  METHODS
  Twenty patients who underwent abdominal surgery for malignant carcinoma were included in this prospective study. Portal blood samples were taken for the measurement of cytokine and endotoxin levels during abdominal surgery. Systemic blood samples were simultaneously collected for the determination of cytokine, endotoxin, and S-IgA levels. After surgery, serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and S-IgA were measured on the 1st, 7th, and 14th, postoperative days.
  
  
  RESULTS
  Circulating S-IgA levels correlated with interleukin-6 levels (r = 0.48, P < .05), but not with interleukin-1 or endotoxin levels in the portal circulation. In the postoperative period, the best correlation between serum S-IgA and other biochemical parameters was found with alkaline phosphatase (r = 0.87, P < .01), followed by alanine aminotransferase (r = 0.70, P < .01).
  
  
  CONCLUSIONS
  Interleukin-6 in the portal blood might stimulate synthesis and/or regurgitation from bile into the systemic circulation of S-IgA. Circulating levels of S-IgA appeared as a sensitive marker for postoperative cholestatic liver damage.
authors.affiliation: First Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujita
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Saeki
authors.forename: K
authors.initials: K
authors.lastname: Itsubo
mesh_terms: D000008:Abdominal Neoplasms / Q000097:blood* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D004731:Endotoxins; D007071:Immunoglobulin A, Secretory; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha