Effects of perioperative protease inhibitor on inflammatory cytokines and acute-phase proteins in patients with hepatic resection.
OBJECTIVE
The objective of this study was to examine the effects of perioperative administration of ulinastatin, or urinary trypsin inhibitor (UTI), on inflammatory cytokines and acute-phase proteins induced by inflammatory cytokines in patients who had undergone hepatic resection.


METHODS
Twenty patients admitted to the hospital for hepatic resection were equally randomized to one of two groups: the UTI group, those who were administered perioperative UTI, and the control group.


RESULTS
The UTI group had no adverse effects from using UTI. Production of serum interleukin-6 (IL-6) tended to be attenuated in the UTI group when compared with the control group. Moreover, the UTI group had significantly decreased positive acute-phase C-reactive protein (p < 0.05) and significantly increased negative acute-phase protein prealbumin and retinol-binding protein (p < 0.05). Serum IL-6 levels significantly correlated with serum C-reactive protein levels on postoperative day 1 (r = 0.70, p < 0.01).


CONCLUSIONS
These results suggest that perioperative administration of UTI might deserve further assessment for use in modulating acute-phase responses without adverse effects in patients who have undergone hepatic resection.
Ambiru
S
S
First Department of Surgery, Chiba University School of Medicine, Chiba, Japan.
Miyazaki
M
M
Sasada
K
K
Ito
H
H
Kimura
F
F
Nakagawa
K
K
Shimizu
H
H
Ando
K
K
Nakajima
N
N
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000097:blood*; D005260:Female; D006023:Glycoproteins / Q000008:administration & dosage*; D006498:Hepatectomy; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011228:Prealbumin / Q000378:metabolism; D012177:Retinol-Binding Proteins / Q000378:metabolism; D014361:Trypsin Inhibitors / Q000008:administration & dosage*
D000209:Acute-Phase Proteins; D016207:Cytokines; D006023:Glycoproteins; D015850:Interleukin-6; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D014361:Trypsin Inhibitors; D002097:C-Reactive Protein; C028665:urinastatin