title: Effect of preoperative fever-range whole-body hyperthermia on immunological markers in patients undergoing colorectal cancer surgery.
abstract: BACKGROUND
  Previous studies have demonstrated beneficial immunological effects of fever-range whole-body hyperthermia (FR-WBH) as an adjunct to non-surgical cancer therapy. We conducted a study of preoperative FR-WBH in patients undergoing colorectal cancer surgery to evaluate perioperative, hyperthermia-induced immunomodulation.
  
  
  METHODS
  The trial was conducted as a subject-blinded, controlled, randomized study. Subjects in the FR-WBH group (n=9) were treated with FR-WBH before operation under propofol sedation; the target core temperature was 39 (0.5)°C with 1 h warming and 2 h plateau phase. Subjects in the control group (n=9) were treated with propofol sedation only. Blood samples were acquired before and after treatment, after operation, and 24, 48 h, and 5 days after the end of surgery. The following parameters were measured: lipopolysaccharide (LPS)-induced tumour necrosis factor (TNF)-α, procalcitonin (PCT), interleukin (IL)-6/10, heat shock proteins (HSPs) 60, 70, and 90, human leucocyte antigen-DR (HLA-DR), and LPS-binding protein (LBP).
  
  
  RESULTS
  HSPs were increased in the FR-WBH group after treatment [HSP60, 48 h postop: 143 (41)% vs 89 (42)%, P=0.04; HSP90, postop: 111 (33)% vs 64 (31)%, P=0.04; HSP70: P=0.40; FR-WBH vs control, P-values for area under the level/time curve]. TNF-α levels were elevated after surgery in the control group and remained near baseline in the FR-WBH group [24 h postop: 73 (68)% vs 151 (72)%, P=0.04]. PCT increased in both groups 24 h after surgery; in the control group, this increase was significantly higher (P=0.02). There were no significant differences for IL, HLA-DR, or LBP.
  
  
  CONCLUSIONS
  The immune system to react to surgical stress, as measured by a panel of laboratory indicators, might be improved by preoperative FR-WBH.
authors.affiliation: Division of General Anaesthesia and Intensive Care, Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Sulyok
authors.forename: E
authors.initials: E
authors.lastname: Fleischmann
authors.forename: A
authors.initials: A
authors.lastname: Stift
authors.forename: G
authors.initials: G
authors.lastname: Roth
authors.forename: D
authors.initials: D
authors.lastname: Lebherz-Eichinger
authors.forename: D
authors.initials: D
authors.lastname: Kasper
authors.forename: A
authors.initials: A
authors.lastname: Spittler
authors.forename: O
authors.initials: O
authors.lastname: Kimberger
mesh_terms: D000209:Acute-Phase Proteins / Q000276:immunology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood / Q000276:immunology; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins / Q000097:blood / Q000276:immunology; D015179:Colorectal Neoplasms / Q000097:blood / Q000276:immunology / Q000601:surgery*; D003107:Colorectal Surgery; D005260:Female; D005334:Fever; D006680:HLA Antigens / Q000097:blood / Q000276:immunology; D006360:Heat-Shock Proteins / Q000097:blood / Q000276:immunology; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D056747:Immunomodulation / Q000276:immunology*; D016753:Interleukin-10 / Q000097:blood / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood / Q000276:immunology; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood / Q000276:immunology; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011498:Protein Precursors / Q000097:blood / Q000276:immunology; D016037:Single-Blind Method; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000276:immunology; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins; D006680:HLA Antigens; D006360:Heat-Shock Proteins; D016753:Interleukin-10; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D011498:Protein Precursors; D014409:Tumor Necrosis Factor-alpha; D000099231:Lipopolysaccharide-Binding Protein; C000606589:CALCA protein, human