title: Inflammatory cytokines in relation to adrenal response following total hip replacement.
abstract: Our objective was to investigate the initiation and course of pro- and anti-inflammatory cytokines in early inflammatory response and to elucidate the cytokine system in relation to the adrenal response caused by stress. Seven blood samples were collected, pre- and postoperatively (0-72 h) after total hip replacement (THR) due to osteoarthritis. The following cytokines were measured using Cytometric Bead Array: interleukin-1beta (IL-1beta), IL-6, tumour necrosis factor-alpha, IL-8, IL-12 and IL-10 (B&D). Thirteen patients took part in the study (67 +/- 9 years). C-reactive protein increased from <6 to over 200 mg/l on the second post-op day. The concentration of IL-6 increased 10-fold just 3 h post-op (4-47 pg/ml) and reached its maximum value 6 h post-op (77 pg/ml; Wilcoxon test P < 0.01) Repeated measurements were also significant (Friedman P < 0.05). The concentration of IL-8 doubled the day of surgery but did not reach a significant level (Friedman test =0.069). None of the other cytokines showed any significant changes. The diurnal cortisol rhythm was interrupted after the surgery and there was a significant correlation between the cortisol secretion and IL-6 response. This study demonstrates an isolated elevation in IL-6 levels with only a minor elevation in IL-8 following THR. This pro-inflammatory response seemed to decline without activation of anti-inflammatory cytokines (IL-10), but cortisol seemed to play a complicated role in halting the acute inflammatory response.
authors.affiliation: Centre for Rheumatology Research, Landspitali-University Hospital, Reykjavik, Iceland.
authors.forename: G L
authors.initials: GL
authors.lastname: Bjornsson
authors.forename: L
authors.initials: L
authors.lastname: Thorsteinsson
authors.forename: K O
authors.initials: KO
authors.lastname: Gudmundsson
authors.forename: H
authors.initials: H
authors.lastname: Jonsson
authors.forename: S
authors.initials: S
authors.lastname: Gudmundsson
authors.forename: B
authors.initials: B
authors.lastname: Gudbjornsson
mesh_terms: D000311:Adrenal Glands / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10; D002097:C-Reactive Protein; D006854:Hydrocortisone