Secondary peritonitis: severity of disease and activation of peritoneal cells.
OBJECTIVE
To compare the degree of the inflammatory response of human peritoneum with the severity of peritonitis.


METHODS
Clinical laboratory study.


METHODS
University hospital, Germany.


METHODS
15 patients with diffuse secondary peritonitis and 5 having conventional cholecystectomy (controls) had peritoneal specimens taken from the site of incision.


METHODS
Correlation between presence of indicators of the inflammatory response: interleukin 1 (IL-1), interleukin 6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), antibacterial protein (defensin 3 reflecting the activation of granulocytes), the antibody clone HAM 56 (for detection of local macrophages), and antibodies against macrophage migration inhibiting factor (MIF)-related proteins 8 and 14 (MRP 8 and 14), and clinical state evaluated by the Mannheim Peritonitis Index (MPI), the Peritonitis Index Altona II (PIA II) and the Acute Physiology Score (APS). C-reactive protein (CRP) concentrations were measured preoperatively in the serum.


RESULTS
Expression of MRP 8 and 14, HAM 56, and defensin 3 was significantly higher in patients with peritonitis than in controls (p < 0.05). Expression of IL-1 and IL-6 was almost undetectable. ICAM-1 expression correlated significantly with phagocytic activation. There was no correlation between clinical scores, CRP, and immunohistochemically detectable variables.


CONCLUSIONS
The pattern of peritoneal inflammatory reactions is relatively uniform and does not correlate with the clinical grading of severity.
Sendt
W
W
Department of Surgery, University of Freiburg, Germany.
Amberg
R
R
Hassan
A
A
von Specht
B U
BU
Schöffel
U
U
D000328:Adult; D000368:Aged; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010537:Peritoneum / Q000473:pathology*; D010538:Peritonitis / Q000209:etiology / Q000473:pathology*