Increased serum adenosine and interleukin 10 levels as new laboratory markers of increased intra-abdominal pressure.
BACKGROUND
Increased intra-abdominal pressure (IAP), intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are severe complications of surgical interventions with a high rate of mortality. The technique of IAP measurement is accurate, precise, reproducible and cost-effective. However, laboratory measures for monitoring of IAH have not been defined. We investigated the linkage between the serum levels of adenosine and interleukin 10 (IL-10) with IAP.


METHODS
The sera of 25 surgical patients with IAP <12 mmHg and of 45 surgical patients with IAP >12 mmHg were tested. Serum adenosine concentration was measured by HPLC. Serum IL-1β, IL-2, IL-4, IL-10, TNFα, IFNγ and IL-10 were determined by enzyme linked immunosorbent assay (ELISA). CRP was measured by nephelometry.


RESULTS
Significant correlations of IAP were found only with serum levels of adenosine and IL-10. In the sera of patients with IAP >12 mmHg, the levels of both adenosine (1.61 versus 0.06 µM, p < 0.01) and IL-10 (63.23 versus 27.27 pg/ml, p < 0.01) were significantly higher than those in patients with IAP <12 mmHg. Moreover, significant correlations were found between individual patient IAP-adenosine values (r = 0.766, p < 0.001), IAP-IL-10 values (r = 0.792, p < 0.001) and adenosine-IL-10 values (r = 0.888, p < 0.001). A direct linear correlation between IAP-adenosine and IAP-10 values was only observed with IAP >15 (Grade II-IV).


CONCLUSIONS
We report associations between IAP and the serum adenosine and IL-10 levels providing new tools for the laboratory monitoring of IAH as well as further understanding of the pathomechanisms contributing to ACS.
Bodnár
Zsolt
Z
Department of Surgery, Gyula Kenézy Teaching Hospital, Debrecen, Hungary.
Keresztes
Tamás
T
Kovács
Ildikó
I
Hajdu
Zoltán
Z
Boissonneault
Gilbert A
GA
Sipka
Sándor
S
D000005:Abdomen / Q000503:physiopathology*; D000241:Adenosine / Q000097:blood*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003161:Compartment Syndromes / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016753:Interleukin-10 / Q000097:blood*; D007415:Intestinal Obstruction / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis; D010538:Peritonitis / Q000097:blood / Q000175:diagnosis; D011312:Pressure; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis
D015415:Biomarkers; D016753:Interleukin-10; D000241:Adenosine