Peri-operative acute phase response and cytokine releasein women with breast cancer: modulation bypolyadenylic-polyuridylic acid.
OBJECTIVE
Acute phase reactants (APRs) are believed to play an important biological role in trauma, sepsis and malignant disease. We have investigated the induction of the APR, C-reactive protein (CRP), by the biological response modifier, polyadenylic-polyuridylic acid (PAPU) during the peri-operative period.


METHODS
Twenty post-menopausal women with breast cancer undergoing mastectomy were randomized into a double blind, placebo-controlled, parallel group pilot study. PAPU (150 mg) or placebo was given intravenously the day prior to surgery (D -1), the day of surgery (D 0) and post-operatively on days (D 1, 3, 5, 7 and 14). Blood samples were collected on eight different days (D -2, -1, 0, 1, 2, 4, 6 and 18). CRP was significantly elevated in the PAPU group (P<0.05) on days 2 and 4, when compared with patients receiving placebo. The serum levels of cytokines believed to induce hepatic APRs, were also measured.


RESULTS
The serum concentration of IL-6 was elevated on days 1, 2, 4 and 6 (P<0.05), TNF- alpha and IL-1 beta levels were increased on days 1 and 2 (P<0.05), respectively, while the serum level of soluble interleukin-2 receptor (sIL-2R) was elevated above the baseline on days 0, 2, 4, 6 and 18 in the PAPU group, when compared with the baseline.


CONCLUSIONS
This modulation of acute phase response may have important implications for patients with cancer undergoing surgery.
Khan
A L
AL
Department of Surgery, University of Aberdeen, Aberdeen, Foresterhill, AB9 2ZD, UK.
Larsen
F
F
Heys
S D
SD
Eremin
O
O
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000601:surgery; D002097:C-Reactive Protein / Q000378:metabolism*; D016207:Cytokines / Q000097:blood / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008408:Mastectomy; D008875:Middle Aged; D010865:Pilot Projects; D011063:Poly A-U / Q000627:therapeutic use*; D017698:Postmenopause; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000276:Adjuvants, Immunologic; D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D011063:Poly A-U; D002097:C-Reactive Protein