title: Tumour necrosis factor-alpha (TNFalpha) and interleukin-10 are crucial mediators in post-operative systemic inflammatory response and determine the occurrence of complications after major abdominal surgery.
abstract: BACKGROUND
  The course of serum cytokine levels in patients with postoperative systemic inflammatory response syndrome (SIRS) after major abdominal surgery remains currently unclear.
  
  
  METHODS
  Blood was sampled pre- and post-operatively and on days 1 and 2 in 40 patients undergoing major abdominal surgery. Concentrations of tumour necrosis factor-alpha (TNFalpha), interleukin (IL) -6, IL-8, and IL-10 were measured by the LINCOplex assay; those of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) by an enzyme immunoassay.
  
  
  RESULTS
  Compared to their pre-operative values, sTREM-1 was elevated on day 2; TNFalpha on day 1; IL-6 and IL-10 post-operatively and on days 1 and 2; and IL-8 post-operatively and on day 1. The duration of operation correlated with TNFalpha and IL-10 at all sampling times, and with IL-6 post-operatively. There were no differences in cytokine concentrations between patients who exhibited post-operative complications and those who did not. IL-10/TNFalpha below 30 was found in all patients with complications (100%) and in 20 patients without complications (64.5%, p: 0.043).
  
  
  CONCLUSIONS
  SIRS following major surgery is characterised by complex alterations in cytokine concentrations. The balance between TNFalpha and IL-10 seems to determine the occurrence of post-operative complications.
authors.affiliation: 2nd Department of Critical Care Medicine, ATTIKON Hospital, University of Athens, Medical School, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Dimopoulou
authors.forename: Apostolos
authors.initials: A
authors.lastname: Armaganidis
authors.forename: Evangelia
authors.initials: E
authors.lastname: Douka
authors.forename: Irini
authors.initials: I
authors.lastname: Mavrou
authors.forename: Callirhoe
authors.initials: C
authors.lastname: Augustatou
authors.forename: Petros
authors.initials: P
authors.lastname: Kopterides
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Lyberopoulos
authors.forename: Marinella
authors.initials: M
authors.lastname: Tzanela
authors.forename: Stylianos E
authors.initials: SE
authors.lastname: Orfanos
authors.forename: Emilia
authors.initials: E
authors.lastname: Pelekanou
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Macheras
authors.forename: Evangelos J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D015415:Biomarkers; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D011183:Postoperative Complications / Q000097:blood* / Q000473:pathology; D011971:Receptors, Immunologic / Q000097:blood; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000209:etiology* / Q000473:pathology; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10