title: Clinical evaluation of circulating interleukin-6 and interleukin-10 levels after surgery-induced inflammation.
abstract: 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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Miyaoka
authors.forename: Masayasu
authors.initials: M
authors.lastname: Iwase
authors.forename: Rikako
authors.initials: R
authors.lastname: Suzuki
authors.forename: Gen
authors.initials: G
authors.lastname: Kondo
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Masao
authors.initials: M
authors.lastname: Nagumo
mesh_terms: 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
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D013481:Superoxides; D016753:Interleukin-10; D002097:C-Reactive Protein; D010196:Pancreatic Elastase