Clinical evaluation of circulating interleukin-6 and interleukin-10 levels after surgery-induced inflammation.
BACKGROUND
It was previously reported that both pro- and anti-inflammatory cytokines are elevated in systemic inflammatory response syndrome (SIRS). Cytokine-mediated systemic neutrophil activation is a direct consequence of SIRS, and can lead to multiple organ dysfunction syndrome (MODS). This prospective study assessed the risk of SIRS and MODS after orthognathic surgery by measuring the circulating levels of inflammatory cytokines such as IL-6 and IL-10 as well as the neutrophil functions as a marker of organ failure.


METHODS
Blood samples for the measurement of IL-6, IL-10, CRP, neutrophil counts, and neutrophil function were drawn from 21 patients with mandibular prognathism at 2 days before, and at 1 and 3 days after orthognathic surgery. The neutrophil function was estimated by superoxide production and elastase release under the stimulation of FMLP.


RESULTS
Eight of the 21 patients were applicable to SIRS criteria 1 day postoperatively, and all of the subjects were excluded from SIRS criteria 3 days postoperatively. Although IL-6 and IL-10 levels were raised 1 day postoperatively, increased cytokine concentrations were decreased in most patients at 3 days postoperatively. The IL-6 concentration and the ratio of IL-6 to IL-10 were higher in the SIRS-matched group compared with the non-SIRS-matched group. Neutrophil priming for superoxide production and elastase release was discovered 1 day after orthognathic surgery, and differences in those values could not be distinguished between the groups.


CONCLUSIONS
These results suggest that a few patients in whom high levels of circulating inflammatory cytokine and neutrophil-derived toxic factor continue may have a possibility of contracting severe diseases such as SIRS and MODS after orthognathic surgery. We conclude that the ratio of IL-6 to IL-10 may be a predictive factor in SIRS.
Miyaoka
Kenichi
K
Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan.
Iwase
Masayasu
M
Suzuki
Rikako
R
Kondo
Gen
G
Watanabe
Hitoshi
H
Ito
Daisuke
D
Nagumo
Masao
M
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000209:etiology; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood; D009504:Neutrophils / Q000378:metabolism*; D010196:Pancreatic Elastase / Q000378:metabolism; D011237:Predictive Value of Tests; D011378:Prognathism / Q000601:surgery; D012307:Risk Factors; D013481:Superoxides / Q000378:metabolism; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood; D013997:Time Factors
D015415:Biomarkers; D015850:Interleukin-6; D013481:Superoxides; D016753:Interleukin-10; D002097:C-Reactive Protein; D010196:Pancreatic Elastase