[Changes in the cytokine concentration (Il-6, Il-8, Il-1ra) and their cellular expression of membrane molecules (CD25, CD30, HLA-DR) after surgical trauma].
Elective surgical approaches and trauma cause changes in the production of different cytokines, an increased production of acute phase protein and changes in the expression of different cell surface markers.


METHODS
In a prospective study we examined the C-reactive protein level, the production of the cytokines IL-6, IL-8 and IL-1 RA in 25 laparoscopic and 21 conventional cholecystectomies. In addition the cell surface markers CD25 and CD30 on different cell populations and HLA-DR on monocytes were measured. Statistical analysis was made by Student's-t-test and Mann-Whitney's rank sum test.


RESULTS
The humoral markers showed a more distinct increase in patients operated on conventionally two and 24 hours after surgery, the differences between the two surgical approaches were significant (p < 0.01). The cell surface markers CD25 and CD30 showed the same reaction. The HLA-DR expression on monocytes was significantly lower in patients operated on conventionally.


CONCLUSIONS
Elective surgical approaches cause changes in the immune system, which can be evaluated by the reaction of cytokines and cell surface markers. Laparoscopic cholecystectomies cause less activation of the immune system than conventional operations.
Decker
D
D
Klinik und Poliklinik für Chirurgie, Universität Bonn.
Lindemann
C
C
Low
A
A
Bidlingmaier
F
F
Hirner
A
A
von Ruecker
A
A
D000210:Acute-Phase Reaction / Q000175:diagnosis / Q000276:immunology*; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D016207:Cytokines / Q000097:blood*; D005260:Female; D006684:HLA-DR Antigens / Q000097:blood*; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D017730:Ki-1 Antigen / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology*; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012795:Sialoglycoproteins / Q000097:blood; D013601:T-Lymphocytes / Q000276:immunology
D016207:Cytokines; D006684:HLA-DR Antigens; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; D016209:Interleukin-8; D017730:Ki-1 Antigen; D015375:Receptors, Interleukin-2; D012795:Sialoglycoproteins