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Ale? Jerin, Neva Po?ar-Lukanovi?, Valentin Sojar, Dragoje Stanisavljevi?, Vesna Paver-Er?en, Jo?ko Osredkar
Balance of Pro- and Anti-Inflammatory Cytokines in Liver Surgery
Inflammatory response in surgery is associated with the release of cytokines. Many cytokines are produced by macrophages; therefore surgical injuries to the liver may have great influence on the release of cytokines. Ischemia creates tissue injury and may contribute to the cytokine release. A balanced ratio of pro- and anti-inflammatory cytokines is important for appropriate immune response; excessive inflammation or hypo-responsiveness can lead to post-operative complications. To determine the magnitude of the cytokine response caused by liver surgery and to evaluate the balance of pro- and anti-inflammatory cytokines released during the operation, we measured levels of tumor necrosis factor-? (TNF?), interleukin (IL)-1?, IL-6 and IL-10 in 19 patients undergoing liver resection. The results showed a continuous rise of IL-6 and a transient elevation of IL-10. Levels of TNF? remained low; IL-1? was not detected at any sampling time. We conclude that liver surgery induces cytokine response characterized predominantly by an early appearance of IL-6 and IL-10, the elevation of IL-6 may be mainly caused by splanchnic ischemia. The IL-6/IL-10 ratio could possibly reflect the balance of pro- and anti-inflammatory cytokines in liver surgery better than the TNF?/IL-10 ratio, which can well represent inflammatory status in sepsis.
Clinical Chemical Laboratory Medicine, Walter de Gruyter
Print ISSN: 1434-6621
Volume: 41, 07/2003
Pages: 899 - 903