title: The post-operative level of serum monocyte chemoattractant protein-1 and its correlation with the severity of surgical stress.
abstract: BACKGROUND
  Several basic studies have demonstrated that monocyte chemoattractant protein-1 (MCP-1) influences type 2 cytokine production and cell-mediated immunity. However, there have been few reports on the changes in serum MCP-1 levels in patients undergoing major thoracoabdominal surgery. In this study, we examined the kinetics of serum MCP-1 post-operatively and clarified its significance regarding the extent of surgical stress.
  
  
  METHODS
  Seventeen patients who underwent surgical operations were included in this study. All of them were fed by total parenteral nutrition to deliver the same amount of calories and nitrogen. Of the severely stressed group, nine patients underwent esophagectomy with thoracotomy. Of the group of moderately stressed group, eight patients underwent gastric or colorectal surgery. Serum MCP-1 and interleukin-6 (IL-6) were measured after operation. Cell-mediated immunity was measured by concanavalin A- or phytohemagglutinin-stimulated lymphocyte proliferation on the seventh post-operative day.
  
  
  RESULTS
  Serum MCP-1 and IL-6 were increased immediately after surgery in both groups. The level of MCP-1 was significantly higher in the group of severely stressed patients than in the moderately stressed group. Concanavalin A or phytohemagglutinin-stimulated lymphocyte proliferation was significantly lower in the severely stressed group than in the moderately stressed group.
  
  
  CONCLUSIONS
  These results indicate that serum MCP-1 levels are directly correlated, and cell-mediated immunity inversely correlated, with the severity of surgical stress.
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hidehito
authors.initials: H
authors.lastname: Shibasaki
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Yamamori
authors.forename: Fumio
authors.initials: F
authors.lastname: Kimura
authors.forename: Tsuguhiko
authors.initials: T
authors.lastname: Tashiro
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000368:Aged; D002455:Cell Division / Q000187:drug effects / Q000276:immunology; D018932:Chemokine CCL2 / Q000097:blood / Q000276:immunology*; D003208:Concanavalin A / Q000494:pharmacology; D002149:Energy Intake; D016629:Esophagectomy; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D010835:Phytohemagglutinins / Q000494:pharmacology; D011183:Postoperative Complications / Q000097:blood / Q000276:immunology*; D012720:Severity of Illness Index; D013312:Stress, Physiological / Q000097:blood / Q000209:etiology / Q000276:immunology*
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; C508600:IL6 protein, human; D015850:Interleukin-6; D010835:Phytohemagglutinins; D003208:Concanavalin A; D009584:Nitrogen