Effect of ulinastatin on cytokine reaction during gastrectomy.
BACKGROUND
Inflammation plays an important role in the postoperative morbidity of organs, which is related to the activation of pro-inflammatory and anti-inflammatory cytokines. Ulinastatin (Urinary trypsin inhibitor, UTI) is a serine protease inhibitor found in human urine or serum that inhibits the activation of human leukocyte elastase. This study examined the effect of UTI on the inflammation response in patients undergoing a gastrectomy.


METHODS
THIRTY PATIENTS SCHEDULED TO UNDERGO A GASTRECTOMY WERE DIVIDED INTO TWO GROUPS AS FOLLOWS: Control group (untreated, n = 15) and UTI group (100,000 units of UTI were continuously injected intravenously for 2 hours, n = 15). Arterial blood was sampled before surgery (T0), 10 minutes after its onset (T1), at its end (T2), and 1 hour after surgery (T3) to measure the level of cytokines.


RESULTS
Both the control and treatment groups had higher interleukin (IL)-6 levels at T2 and T3 than T0, and the level increased with time. However, the increase was smaller in the treatment group. The IL-8 levels were not activated significantly in any of the groups.


CONCLUSIONS
UTI inhibits the secretion of IL-6, which is an inflammatory cytokine produced after a gastrectomy. This shows that UTI can decrease the inflammation reaction caused by surgical stress.
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea.
Ji Hun
JH
Park
Sang Hyun
SH
Kwak
Cheol Won
CW
Jeong
Hong Beom
HB
Bae
Seok Jai
SJ
Kim