title: Plasma concentration of cytokine antagonists in patients with infection following liver resection.
abstract: BACKGROUND
  The interactions between endogenous cytokine antagonists, surgical injury and perioperative infection are poorly understood.
  
  
  METHODS
  Perioperative plasma concentrations of soluble tumour necrosis factor receptor p55 (STNFR p55), interleukin (IL) 1 receptor antagonist (IL-1ra) and IL-6 were measured by immunoassay in 29 consecutive patients undergoing liver resection.
  
  
  RESULTS
  Plasma concentrations of STNFR p55, IL-1ra and IL-6 showed a striking increase immediately after operation (day 0) and on postoperative day 1. STNFR p55 concentrations correlated significantly with operating time (P< 0.05); IL-1ra levels with operating time, blood loss and weight of resected liver (P < 0.05); and IL-6 concentrations with operating time and blood loss (P< 0.05). Eight of the 29 subjects developed postoperative infections, of whom four had positive cultures of enteric organisms. Plasma STNFR p55 and IL-6 concentrations were significantly higher in the infected group than in the uninfected group (P < 0.05). STNFR p55 and IL-6 concentrations on day 0 differentiated between the two groups with a diagnostic accuracy of 79 and 83 per cent respectively.
  
  
  CONCLUSIONS
  These results suggest that STNFR p55, IL-1ra and IL-6 are produced during operation in response to surgical stress. This production of STNFR p55 and IL-6 may be enhanced further by intraoperative bacterial translocation. Measurement of plasma STNFR and IL-6 concentrations may predict the development of postoperative infectious complications.
authors.affiliation: Department of Surgery, Omiya Red Cross Hospital, Kamiochiai, Yono, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Kimura
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: T
authors.initials: T
authors.lastname: Suwa
authors.forename: T
authors.initials: T
authors.lastname: Sugiura
authors.forename: T
authors.initials: T
authors.lastname: Shinoda
authors.forename: H
authors.initials: H
authors.lastname: Itoh
authors.forename: S
authors.initials: S
authors.lastname: Ambiru
authors.forename: H
authors.initials: H
authors.lastname: Shimizu
authors.forename: K
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007431:Intraoperative Complications / Q000097:blood*; D008107:Liver Diseases / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D013997:Time Factors
chemical_list: D015850:Interleukin-6; D017472:Receptors, Interleukin-1; D018124:Receptors, Tumor Necrosis Factor