Preoperative administration of rebamipide significantly lowers body temperature and circulating interleukin-6 in gastric cancer patients after gastrectomy.
OBJECTIVE
It has recently been reported that rebamipide (OPC-12759) inhibits inflammatory cytokines and activation of neutrophils. The aim of the present study was to investigate the effects of preoperative administration of rebamipide on parameters of systemic inflammatory response syndrome (SIRS) and serum levels of inflammatory cytokines in gastric cancer patients after gastrectomy.


METHODS
We measured the parameters of SIRS, circulating cytokines and acute phase reactants in patients after (i). distal gastrectomy with D2 lymph node dissection (group 1, n = 10); (ii). distal gastrectomy with D2 lymph node dissection following administration of rebamipide (group 2, n = 10), and (iii). laparoscopy-assisted distal gastrectomy (LADG) with D1 lymph node dissection (group 3, n = 10). Group 2 was administered 100 mg of rebamipide 3 times/day after meals for 7 days before surgery.


RESULTS
Among the parameters of SIRS, a difference was observed in body temperature on day 3. The mean body temperature of group 2 was significantly lower than group 1 (p = 0.006), and was similar to group 3. In proinflammatory cytokines, a significant difference was observed in the serum levels of interleukin (IL)-6. On day 1 the IL-6 levels of group 2 were significantly lower than those of group 1 (p < 0.001). The changes in the IL-6 level of group 2 were similar to group 3, except in the very early postoperative phase. However, other proinflammatory cytokines, such as IL-8 and IL-10, were not detected, and there was no difference in C-reactive protein between the 3 groups.


CONCLUSIONS
Preoperative administration of rebamipide significantly decreased postoperative body temperatures and circulating IL-6 in gastric cancer patients after gastrectomy to levels similar to those of patients with LADG.
D000368:Aged; D000409:Alanine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D018890:Chemoprevention / Q000379:methods; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D005334:Fever / Q000517:prevention & control; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015363:Quinolones / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000601:surgery*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D016896:Treatment Outcome
D004791:Enzyme Inhibitors; D015850:Interleukin-6; D015363:Quinolones; C052785:rebamipide; D000409:Alanine