Gender-specific differences in sex hormones and cytokines in patients undergoing major abdominal surgery.
OBJECTIVE
Experimental and clinical evidence suggests that gender has a profound influence on outcome after inflammatory hits caused by such events as trauma. We conducted this prospective clinical study to evaluate the influence of gender on the release of pro- and anti-inflammatory cytokines in the circulation and after lipopolysaccharide (LPS) ex vivo stimulation. We also measured the course of sex hormones in the acute phase response after surgery and assessed their correlation with cytokine release.


METHODS
We measured the serum concentrations of interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-alpha), testosterone, estradiol, prolactin, procalcitonin, and sex hormone-binding globulin, as well as the release of IL-6, TNF-alpha, and IL-10 after LPS ex vivo stimulation of whole blood in 26 patients without complications after major or minor abdominal surgery.


RESULTS
There was a gender-specific pattern of decreasing testosterone concentrations in men and increasing testosterone concentrations in women. Increasing estradiol concentrations were seen in both men and women. The ex vivo-stimulated and systemic IL-6, IL-8, IL-10, and TNF-alpha cytokine release was not gender specific. There was a marked prolactin peak after the induction of anesthesia before the commencement of surgery.


CONCLUSIONS
In contrast to the release of pro- and anti-inflammatory cytokines, sex hormones show a gender-specific pattern during the acute phase response 1 week after abdominal surgery.
Scheingraber
Stefan
S
Department of Surgery, University of the Saarland, Homburg, Germany.
Dobbert
Daniel
D
Schmiedel
Peter
P
Seliger
Ewald
E
Dralle
Henning
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D016753:Interleukin-10 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012737:Sex Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D015415:Biomarkers; D016207:Cytokines; D012739:Gonadal Steroid Hormones; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10