title: Assessment of plasma B7-H3 levels in pediatric patients with different degrees of surgical stress.
abstract: Surgical stress initiates a series of host hormone, metabolism and immune responses, which predominantly affect the homeostatic mechanism of patients with major surgery. B7-H3 is a co-stimulatory molecule and has been shown to participate in both adaptive and innate immune responses. In this study we evaluated the clinical significance of plasma B7-H3 levels in pediatric patients with different types of operation and degrees of surgical stress.
  
  
  
  A total of 48 children received pediatric general and cardiac surgery were recruited into this study. Based on the surgical stress scoring, children were divided into moderate stress (n = 14) and severe stress (n = 34) groups. Plasma B7-H3 levels were assessed at selected time points: before surgery, immediately after surgery, at day 1, day 3, and day 7 after surgery. Correlations between plasma B7-H3 levels and surgical stress scores were also examined.
  
  
  
  Plasma B7-H3 levels were significantly decreased in all 48 pediatric patients after surgery compared to the B7-H3 level before surgery (p < 0.01). Children with general surgery showed significant decreases in plasma B7-H3 immediately after surgery, and at day 3 and day 7 after surgery (p < 0.05, p < 0.01), whereas children with cardiac surgery showed reduced plasma B7-H3 immediately after surgery and at day 3 after surgery (p < 0.05). Plasma B7-H3 in cardiac surgery group was dropped much lower than that in general surgery group at day 1 (p < 0.05) and day 3 (p < 0.01) after surgery. Significantly reduced plasma B7-H3 was observed in the severe stress group, but not in the moderate stress group, immediately after surgery and at day 3 after surgery (p < 0.05), and severe stress group had significantly lower plasma B7-H3 levels than moderate stress group at day 1, day 3, and day 7 after surgery (p < 0.05). Furthermore, plasma B7-H3 levels at day 1 (p = 0.01) and day 3 (p = 0.025) after surgery correlated negatively with surgical stress scores.
  
  
  
  Plasma B7-H3 levels were decreased significantly in children subjected to pediatric general and cardiac surgery, which is closely associated with the severity of surgical stress. The negative correlation of plasma B7-H3 levels at day 1 and day 3 after surgery with surgical stress scoring implicates that the plasma B7-H3 level might be a useful biomarker for monitoring stress intensity during pediatric surgery.
authors.affiliation: Department of Pediatric Surgery, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: Department of Pediatric Cardiology, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.affiliation: Institute of Pediatric Research, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China.
authors.forename: Yi Ping
authors.initials: YP
authors.lastname: Li
authors.affiliation: Institute of Pediatric Research, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of Neonatology, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Feng
authors.affiliation: Institute of Medical Biotechnology, Soochow University, Suzhou, 215006, China.
authors.forename: Xue Guang
authors.initials: XG
authors.lastname: Zhang
authors.affiliation: Department of Academic Surgery, University College Cork, Cork University Hospital, Cork, Ireland. jh.wang@ucc.ie.
authors.forename: Jiang Huai
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Pediatric Surgery, Affiliated Children's Hospital, Soochow University, Suzhou, 215003, China. wj196312@gmail.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D060887:B7 Antigens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011184:Postoperative Period; D057234:Preoperative Period; D013312:Stress, Physiological / Q000276:immunology*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
chemical_list: D060887:B7 Antigens; D015415:Biomarkers; C423237:CD276 protein, human
keywords: B7-H3; Children; Pediatric surgery; Surgical stress