Factors Influencing the Increase of Serum IL-6 Concentration in Surgical Patients

Kiyoshi Sakamoto, Hirofumi Arakawa, Seiji Mita, Takaaki Ishiko, Hiroki Sugita, Hirofumi Samejima, Hiroshi Egami, Satoshi Ikei, Michio Ogawa

Department of Surgery II, Kumamoto University Medical School

To determine the role of cytokines in the host defense in surgical patients, we investigated the kinetics of post-operative elevation of cytokines and factors influencing the increase in serum IL-6 concentration in 38 patients who underwent elective surgery. Serum IL-6 levels reached the maximum on the lst post-operative day in all patients. Concentrations of IL6 and IL-8 in the drain exudate were significantly higher than those in the peripheral blood. Strong expression of m RNAs of IL-6 and IL-8 was observed in the leukocytes in the exudate of the thorax and abdomen during the operative and 1st and 2nd post-operative days. On the other hand, there was little expression of these mRNAs in the peripheral leukocytes. Significant correlations were observed between peak serum values of IL-6 and operation time or volume of blood loss during surgery. These results suggest that (1) cytokines are mainly induced and produced in the operative field and subsequently spill over into the blood, inducing hypercytokinemia, and (2) operation time and volume of blood loss during surgery are factors influencing the production of cytokines.

Key words
cytokine, surgical stress, interleukin 6, interleukin 8

Reprint requests
Kiyoshi Sakamoto Department of Surgery II, Kumamoto University Medical School
1-1-1 Honjo, Kumamoto, 860 JAPAN

Accepted
July 6, 1992

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