Circulating interleukin 6 as a useful marker for predicting postoperative complications

Oka, Yoshio; Murata, Atsuo; Nishijima, Junichi; Yasuda, Tadashi; Hiraoka, Nobuaki; Ohmachi, Yoshitaka; Kitagawa, Katsumi; Yasuda, Takushi; Toda, Hitoshi; Tanaka, Nobuo; Mori, Takesada

doi:10.1016/1043-4666(92)90070-8

Cited by 113 publications

(66 citation statements)

References 31 publications

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“…Similar observations were reported for renal carcinoma (28,29). Also, in postoperative patients, strongly elevated IL-6 levels (.400 pg/ml) are predictive of complications (30). A negative correlation between IL-6 and T 3 serum levels has been observed clinically even at mildly elevated IL-6 levels (.15 pg/ml) (31).…”

Section: Discussionsupporting

confidence: 70%

Proinflammatory cytokines inhibit the expression and function of human type I 5'-deiodinase in HepG2 hepatocarcinoma cells

Jakobs¹,

Mentrup²,

Schmutzler³

et al. 2002

European Journal of Endocrinology

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Objective: The sick euthyroid syndrome in critically ill patients without primary disease of the thyroid gland is characterised by low serum total triiodothyronine (T 3 ), normal to elevated thyroxine (T 4 ), elevated reverse T 3 (rT 3 ) and normal TSH levels. The aim of this work was to clarify if impaired T 4 and rT 3 5 0 -deiodination is an underlying mechanism. Design and Methods: We analysed the effect of the human recombinant proinflammatory cytokines interleukin (IL)-6 and IL-1b, tumour necrosis factor-a (TNF-a) and interferon-g (IFN-g) on human type I 5 0 -iodothyronine deiodinase (5 0 DI) enzyme activity in the human hepatocarcinoma cell line HepG2, i.e. in a homologous human system. Furthermore, we analysed transcriptional effects of the cytokines by transient transfection assays using the luciferase or chloramphenicol acetyltransferase (CAT) reporter genes under the control of 1480 nucleotides of the human 5 0 DI promoter. Results: IL-6 at 500 pg/ml and TNF-a at 25 ng/ml had no significant effect, whereas 100 ng/ml IFN-g or 10 ng/ml IL-1b reduced 5 0 DI enzyme activity to 77.9 and 59.5% of control values. IFN-g did not alter, IL-6 and TNF-a moderately decreased (in the case of IL-6 only in the CAT system), and IL-1b (0.01 -10 ng/ml) dose-dependently inhibited 5 0 DI promoter activity to a minimum of 38.1%. Conclusion: IL-1b inhibited both 5 0 DI enzyme and promoter activity and, thus, may exert its effect on thyroid hormone metabolism at least partially through direct inhibition of hepatic 5 0 DI gene transcription.

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Section: Discussionsupporting

confidence: 70%

Proinflammatory cytokines inhibit the expression and function of human type I 5'-deiodinase in HepG2 hepatocarcinoma cells

Jakobs¹,

Mentrup²,

Schmutzler³

et al. 2002

European Journal of Endocrinology

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“…Mean serum levels of IL-6 on POD 1 were significantly (88 vs. 34 pg/mL, P ϭ 0.034) higher in the group of patients with postoperative complications. The median postoperative hospital stay was 8 days (range, 5-39) in the control group and 6 days (range, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] in the steroid group (P ϭ 0.003).…”

Section: Postoperative Complications and Hospital Staymentioning

confidence: 99%

“…4,5 Raised levels of inflammatory cytokines have been related to higher postoperative mortality and morbidity rates. 2,3,6 Therefore, increased attention has evolved toward modulating potentially deleterious inflammatory response to the operation.The anti-inflammatory and immune modulating effects of steroids have been known for decades and have found extensive therapeutic use in a wide range of diseases in which inflammatory responses play major role. 7,8 Several trials have investigated the benefits of administering corticosteroids as a modulator of cytokine response in patients undergoing elective cardiothoracic or gastrointestinal surgery, as well as in cases of septic shock, suggesting that several aspects of the surgical stress responses, organ dysfunction, and postAbbreviations: POD, postoperative day; ALT, alanine aminotransferase; AT-III, antithrombin III; AST, aspartate aminotransferase; TNF-␣, tumor necrosis factor alpha; IL-6, interleukin 6; I/R, ischemia-reperfusion.…”

mentioning

confidence: 99%

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Impact of preoperative steroids administration on ischemia-reperfusion injury and systemic responses in liver surgery: A prospective randomized study

et al. 2006

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Hepatic injury secondary to warm ischemia-reperfusion (I/R) injury and alterations in haemostatic parameters are often unavoidable events after major hepatic resection. The release of inflammatory mediator is believed to play a significant role in the genesis of these events. It has been suggested that preoperative steroid administration may reduce I/R injury and improve several aspects of the surgical stress response. The aim of this prospective randomized study was to investigate the clinical benefits on I/R injury and systemic responses of preoperatively administered corticosteroids. Seventy-six patients undergoing liver resection were randomized either to a steroid group or to a control group. Patients in the steroid group received preoperatively 500 mg of methylprednisolone. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, coagulation parameters, and inflammatory mediators, interleukin 6 and tumor necrosis factor alpha were compared between the 2 groups. Length of stay, and type and number of complications were recorded as well. Postoperative serum levels of ALT, AST, total bilirubin, and inflammatory cytokines were significantly lower in the steroid than in the control group at postoperative days 1 and 2. Changes in hemostatic parameters were also significantly attenuated in the steroid group. In conclusion, the incidence of postoperative complications in the steroid group tended to be significantly lower than the control group. It is of clinical interest that preoperative steroids administration before major surgery may reduce I/R injury, maintain coagulant/anticoagulant homeostasis, and reduce postoperative complications by modulating the inflammatory response. The human body reacts to surgical stimuli through various systemic responses including the endocrine, metabolic, coagulation, and immune systems. However, extended damage may result in an exaggerated systemic response with an overwhelming activation of immune cells and the release of various mediators of stress. [1][2][3] The systemic reaction to the operation is considered to be equivalent to the systemic inflammation response syndrome, mainly caused by cytokine networks. 4,5 Raised levels of inflammatory cytokines have been related to higher postoperative mortality and morbidity rates. 2,3,6 Therefore, increased attention has evolved toward modulating potentially deleterious inflammatory response to the operation.The anti-inflammatory and immune modulating effects of steroids have been known for decades and have found extensive therapeutic use in a wide range of diseases in which inflammatory responses play major role. 7,8 Several trials have investigated the benefits of administering corticosteroids as a modulator of cytokine response in patients undergoing elective cardiothoracic or gastrointestinal surgery, as well as in cases of septic shock, suggesting that several aspects of the surgical stress responses, organ dysfunction, and postAbbreviations: POD, postoperative day; ALT, alanine aminotr...

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“…Cellular damage resulting from injury, such as the surgical incision, leads to the activation of the inflammatory response resulting in local effects on the biochemical and pathophysiologic pathways of inflammation, edema, pain and fever [12,13]. Local prostaglandin induced activation of nociceptors results in the peripheral sensitization of the nervous system, leading to the acute pain response, known as primary hyperalgesia [14,15].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Analgesia in Spine Surgery: A Commentary

DH¹,

BC²

2015

J Pain Relief

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Circulating interleukin 6 as a useful marker for predicting postoperative complications

Cited by 113 publications

References 31 publications

Proinflammatory cytokines inhibit the expression and function of human type I 5'-deiodinase in HepG2 hepatocarcinoma cells

Proinflammatory cytokines inhibit the expression and function of human type I 5'-deiodinase in HepG2 hepatocarcinoma cells

Impact of preoperative steroids administration on ischemia-reperfusion injury and systemic responses in liver surgery: A prospective randomized study

Multimodal Analgesia in Spine Surgery: A Commentary

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