Cytokines and acute-phase response markers derangements in patients with obstructive jaundice.
OBJECTIVE
Prolonged acute-phase response and increase of cytokines have been associated with higher mortality and surgical complications. This study investigated the status of cytokines and acute-phase response markers in patients with obstructive jaundice.


METHODS
Forty-one patients were investigated. Endotoxin, tumor necrosis factor-alpha, interleukin-6, nitric oxide, C-reactive protein, liver enzymes, albumin and percentage of weight loss were determined at admission.


RESULTS
Endotoxin, interleukin-6 and C-reactive protein were significantly elevated in both benign and malignant obstructive jaundice. Increased plasma levels of tumor necrosis factor-alpha were only detected in malignant tumors (68 vs. 24 pg/mL; P < 0.001). Patients with positive acute-phase response (C-reactive protein > mean + 2 SD of controls) had greater weight loss (P = 0.02), endotoxin (P = 0.03) and interleukin-6 plasma levels (P = 0.05) than those with no inflammatory response. Prolonged biliary obstruction (> 10 days) was associated with higher weight loss (P = 0.04), tumor necrosis factor-alpha (P = 0.003) and interleukin-6 (P = 0.05) plasma levels.


CONCLUSIONS
A prolonged high-grade biliary tract obstruction prompted an increase in endotoxin levels, associated with a positive acute-phase response and cytokine elevation.
Padillo
F J
FJ
Department of Surgery, Hospital Reina Sofia, Cordoba, Spain. med026014@nacom.es
Andicoberry
B
B
Muntane
J
J
Lozano
J M
JM
Miño
G
G
Sitges-Serra
A
A
Solorzano
G
G
Pera-Madrazo
C
C
D000209:Acute-Phase Proteins / Q000032:analysis*; D000368:Aged; D002779:Cholestasis / Q000097:blood* / Q000209:etiology; D004067:Digestive System Neoplasms / Q000150:complications; D004731:Endotoxins / Q000097:blood*; D005260:Female; D042882:Gallstones / Q000150:complications; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D000209:Acute-Phase Proteins; D004731:Endotoxins; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha