title: Perioperative pattern of peritoneal interleukin 8, tumour necrosis factor-alpha, and granulocyte elastase release in human secondary peritonitis.
abstract: Cytokine levels during infection and sepsis have been extensively studied in the past. In contrast to the excellent data on tumour necrosis factor alpha (TNF-alpha), interleukin 8 (IL-8), and polymorphonuclear (PMN) granulocyte elastase (PMN-E) concentrations in blood, little is known about cytokine and PMN-E levels in tissue or local fluids like abdominal exudate in secondary, purulent peritonitis of man. Therefore, the authors studied perioperative intra-abdominal levels of TNF-alpha, IL-8 and PMN-E in 21 patients with severe purulent peritonitis. The average pre-operative levels of TNF-alpha were 694 +/- 239 pg/ml in exudate and 26 +/- 6 pg/ml in plasma, for IL-8 100 +/- 34 ng/ml and 0.7 +/- 0.5 ng/ml, and for PMN-E 68 +/- 14 microg/ml and 0.7 +/- 0.1 microg/ml, respectively. Standard surgical procedures reduced the intra-abdominal concentrations of cytokines and PMN-E to as low as one tenth of the pre-operative levels. Postoperatively, TNF-alpha and IL-8 levels recovered rapidly and pre-operative levels of IL-8 were reached again after 1 h and for TNF-alpha after 8 h. PMN-E concentration remained below the initial baseline within 8 h of observation. TNF-alpha concentration, but not IL-8 or PMN-E, depended on the microbiological load of the abdominal exudate (< or > 10(3) cfu/ml). There were no significant differences in the intra-abdominal or plasma levels of cytokines or PMN-E between survivors and non-survivors at any observation time.
authors.affiliation: Department of Anaesthesia, University of Regensburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Fröhlich
authors.forename: R M
authors.initials: RM
authors.lastname: Eiber
authors.forename: M
authors.initials: M
authors.lastname: Jochum
authors.forename: A
authors.initials: A
authors.lastname: Billing
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005122:Exudates and Transudates / Q000737:chemistry / Q000201:enzymology / Q000276:immunology; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000097:blood / Q000737:chemistry*; D019272:Leukocyte Elastase / Q000097:blood / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood / Q000201:enzymology* / Q000503:physiopathology / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000737:chemistry*
chemical_list: D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D019272:Leukocyte Elastase