Circulating cytokines, chemokines, and stress hormones are increased in patients with organ dysfunction following liver resection.

Abstract

BACKGROUND:

Humoral mediators are potentially involved in the pathogenesis of postoperative complications following surgery. The aim of the present study is to evaluate the postoperative responses of circulating cytokines, chemokines, and stress hormones following liver resection, and their effects on postoperative infectious complications and organ dysfunction.

PATIENTS AND METHODS:

Perioperative plasma concentrations of interleukin (IL)-6, IL-10, IL-4, IL-8, macrophage chemoattractant protein (MCP)-1, cortisol, macrophage migration inhibitory factor (MIF), and leptin were measured by immunoassays in 128 consecutive patients undergoing liver resection.

RESULTS:

Forty-three patients had postoperative infection and 11 had infection-related organ dysfunction. Plasma levels of all mediators except for IL-4 increased postoperatively. Postoperative levels of IL-6, IL-10, IL-8, MCP-1, cortisol, and leptin were significantly higher in patients with organ dysfunction than in those without organ dysfunction (P < 0.05). However, postoperative MIF levels were not affected by postoperative infection or organ dysfunction. Plasma levels of IL-6, IL-10, IL-8, and MCP-1 were positively correlated with operation time (P < 0.0001) or blood loss (P < 0.0001), and higher in patients with jaundiced liver (P < 0.05). In univariate logistic regression analyses, elevated IL-6, IL-10, IL-8, and MCP-1, advanced age, large volume of blood loss, long operation time, long hepatic ischemia time, and major liver resection were significantly correlated with postoperative infection (P < 0.05). In multivariate analyses, IL-6 and IL-10 were significant predisposing factors for postoperative infection (P < 0.05), and blood loss and IL-6 for organ dysfunction (P < 0.01).

CONCLUSIONS:

These results suggest that IL-6, IL-10, IL-8, MCP-1, cortisol, and leptin are released after liver resection in response to surgical stress and correlated with postoperative infection and organ dysfunction, and that of these circulating mediators, IL-6 and IL-10, have a close relationship to the complications.

• Authors: Fumio Kimura, Hiroaki Shimizu, Hiroyuki Yoshidome, Masayuki Ohtsuka, Atsushi Kato, Hideyuki Yoshitomi, Satoshi Nozawa, Katsunori Furukawa, Noboru Mitsuhashi, Shigeaki Sawada, Dan Takeuchi, Satoshi Ambiru, Masaru Miyazaki
• Journal: The Journal of surgical research (J Surg Res) Vol. 133 Issue 2 Pg. 102-12 (Jun 15 2006) ISSN: 0022-4804 [Print] United States
• PMID: 16386757 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Chemokine CCL2
• Cytokines
• Interleukin-6
• Interleukin-8
• Leptin
• Macrophage Migration-Inhibitory Factors
• Interleukin-10
• Interleukin-4
• Hydrocortisone

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Chemokine CCL2 (blood)
• Cytokines (blood)
• Female
• Humans
• Hydrocortisone (blood)
• Infections (blood, immunology)
• Interleukin-10 (blood)
• Interleukin-4 (blood)
• Interleukin-6 (blood)
• Interleukin-8 (blood)
• Leptin (blood)
• Linear Models
• Liver Diseases (surgery)
• Macrophage Migration-Inhibitory Factors (blood)
• Male
• Middle Aged
• Multiple Organ Failure (blood, immunology)
• Postoperative Complications (blood, immunology)
• Stress, Physiological (blood, immunology)
• Treatment Outcome