Serum Protein Response to Surgery and Starvation

Smale, Brian F.; Hobbs, Charles L.; Mullen, James L.; Rosato, Ernest F.

doi:10.1177/0148607182006005395

Cited by 14 publications

(6 citation statements)

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“…APR to tissue trauma (Kushner, 1982) is related to the insult type and its magnitude (Fouad et al, 1992;McCracken et al, 1984). In humans, alterations of plasma APR levels are an important response to starvation (Smale et al, 1982), infection (Evans et al, 1980), or surgical injury (Aronsen et al, 1972;Colley et al, 1983). A multiple APR has been observed after acute myocardial infarction (Kushner et al, 1978), surgical injury (Voulgari et al, 1982), severe head injury (Ferard et al, 1981), and with the development of sepsis (Witte et al, 1982).…”

mentioning

confidence: 99%

Acute-Phase Response in Rat to Carbon Tetrachloride-Azathioprine Induced Cirrhosis and Partial Hepatectomy of Cirrhotic Liver

Fouad

Mamer²,

Shahidi³

1996

Journal of Toxicology and Environmental Health

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Irreversible liver cirrhosis was induced in rats by supplementing their diet with 0.02% azathioprine and intubating them twice a week with carbon tetrachloride in corn oil. Over period of 3 mo, intoxicated rats showed an atypical acute-phase reaction (APR). The relative concentrations of haptoglobin, beta-lipoprotein, alpha-1-antitrypsin, an unknown peak "X, " and transferrin increased exponentially following a mild initial drop, while albumin, C3c + C3, alpha-1-acid glycoprotein, alpha-1-lipoprotein, and macroglobulin declined continually during the experiment. The accumulated peritoneal fluid was found to contain a similar spectrum of APR proteins. On the other hand, histological examination revealed gradual liver damage manifested as a gradual increase in the areas of collagen separating liver cells, and at the end of the experiment, severe liver damage was evident with isolated hepatocytes in a matrix of collagen. The available data point to the disparity that exists between the physical status of hepatocytes and their biochemical function, which suggests that the remaining metabolically fatigued hepatocytes of the cirrhotic liver continue to biosynthesize and release elevated concentrations of some secretable APR proteins and less of others. Changes in the spectrum of APR plasma components during the progression of inflammatory or physical lesion remain a valid biochemical measure of the pathological function of the acutely intoxicated liver. Partial hepatectomy (PH) of cirrhotic liver displayed a mute APR and no regenerative activity of the remnant hepatic tissue, most likely due to the substantial depletion of hepatic DNA and possible chemical damage to DNA of the remaining viable hepatocytes. A possible cause for the depressed APR to the surgical insult of PH is that the initial azathioprine-CCl4 intoxication had maximally affected APR gene expression and a second injury would then elicit minimal further changes in mRNA levels. Thus, in a compounded pathological condition, the initial inflammatory stimulus on various pre-rRNAs, rRNAs, and mRNAs is rate-limiting to the hepatic biosynthesis and secretion of APR proteins and may not respond linearly, if at all, to a second stimulus.

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confidence: 99%

Acute-Phase Response in Rat to Carbon Tetrachloride-Azathioprine Induced Cirrhosis and Partial Hepatectomy of Cirrhotic Liver

Fouad

Mamer²,

Shahidi³

1996

Journal of Toxicology and Environmental Health

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“…The lack of PTH response indicates that calcium in conjunction with other factors may blunt the normal PTH response. Calcium is a known regulator of 1‐alpha hydroxylase activity and PTH secretion . Albumin corrected calcium increased significantly after surgery and could theoretically augment the observed 35% decrease in serum 1,25(OH) 2 D 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Injury or trauma induces a series of metabolic, inflammatory, and endocrine changes known as the “surgical stress response.” A particular and abrupt event in response to surgery is a profound change in the distribution of proteins between the intra‐ and extravascular compartments . This redistribution gives rise to an instant reduction in the concentration of most circulating proteins, which necessitates immediate changes in factors dependent on protein binding in serum, for instance, calcium and steroid hormones …”

Section: Introductionmentioning

confidence: 99%

“…(1)(2)(3)(4)(5) A particular and abrupt event in response to surgery is a profound change in the distribution of proteins between the intra-and extravascular compartments. (6)(7)(8) This redistribution gives rise to an instant reduction in the concentration of most circulating proteins, which necessitates immediate changes in factors dependent on protein binding in serum, for instance, calcium and steroid hormones. (9) Elective orthopedic surgeries are common in elderly patients suffering from multiple comorbidities, including impaired bone remodeling, who may benefit from interventions facilitating bone formation, ingrowth of implants, or fracture repair.…”

Section: Introductionmentioning

confidence: 99%

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Compromised Activation of Vitamin D After Elective Surgery: A Prospective Pilot Study

et al. 2018

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Surgical stress reduces concentrations of most proteins in serum and necessitates a rapid adjustment of hormones dependent on protein binding. Activation of vitamin D by renal 1α‐hydroxylation is dependent on protein binding because 1,25‐dihydroxyvitamin D (1,25(OH)2D3) is formed after megalin‐mediated reabsorption of 25‐hydroxyvitamin D (25OHD) bound to vitamin D binding protein (DBP). Postoperative alterations in serum concentrations of DBP and albumin may therefore impair 1,25(OH)2D3 production. Our objective was to determine sex‐specific changes in serum concentrations of vitamin D metabolites and sex steroids 2, 6, 24, and 48 hours and 3 weeks postoperatively. Fourteen women and eleven men aged 45 to 77 years without severe comorbidities undergoing unilateral total knee arthroplasty participated in this prospective study in a tertiary center for arthroplasty (trial ID: NCT02336932). The main outcome measures were total and free serum concentrations of 25OHD, 1,25(OH)2D3, 24,25‐dihydroxyvitamin‐D, DBP, albumin, sex hormone binding globulin (SHBG), calcium, and parathyroid hormone (PTH). Serum albumin and SHBG decreased postoperatively (Δalbumin48h −18% [−22%; −14%]). Unexpectedly, concentrations of DBP and 25OHD remained unaltered, but 1,25(OH)2D3 declined postoperatively. 1,25(OH)2D3 was 3 weeks after surgery −24% (−40%; −8%) lower than preoperative levels, whereas 24,25‐dihydroxyvitamin‐D remained unchanged in postmenopausal women. The calculated conversion rate of 25OHD to 1,25(OH)2D3 was strongly associated with serum 25‐OHD and PTH preoperatively, whereas serum calcium was most predictive postoperatively. In conclusion, surgery had no effect on serum concentrations of DBP, 25OHD, and PTH, whereas production of 1,25(OH)2D3 was markedly reduced. Further studies are needed to determine duration and putative outcome effects of this postoperative 1,25(OH)2D3 deficit in women, which in part may be due to discordance in CYP27B1 and CYP24A1 activity. © 2018 American Society for Bone and Mineral Research.

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“…4). Smale et al 25 ) have reported that the TTR level in macaques was not altered by 7 days of starvation, and that the addition of surgical stress significantly decreased the TTR level. The cause of the difference in TTR response to starvation and surgical stress between the rat and macaque is not clear.…”

Section: Effect Of the Acute-phase Response On Plasma Rapid-turnovermentioning

confidence: 99%

Effect of Laparotomy and/or Starvation on the Plasma Rapid-turnover Protein Level in Rats

Matsumoto

Iwasawa

Shima

et al. 1994

Bioscience, Biotechnology, and Biochemistry

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Plasma transferrin (Tf), transthyretin (TTR), and retinol-binding protein (RBP) have been proposed to be sensitive nutritional parameters. We investigated the effect of laparotomy and/or starvation on these plasma protein levels in rats. Starvation decreased the Tf, TTR, and RBP levels to 62.2%, 41.2%, and 52.0% of the initial values, respectively, until day 3, but then sustained the day-3 levels on day 4. In the starved and laparotomized rats, the TTR level on day 1 and the RBP level on day 2 were more decreased than those in the only-laparotomized rats. Recovery of the TTR and RBP levels in the laparotomized rats fed on a stock diet ad libitum was very slow. In conclusion, the plasma Tf, TTR, and RBP levels showed different responses according to the metabolic phase of starvation. Laparotomy affected differently each of these levels, but the decrease in these protein levels was mainly dependent on the nutritional condition of the laparotomized rats.

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Serum Protein Response to Surgery and Starvation

Cited by 14 publications

References 14 publications

Acute-Phase Response in Rat to Carbon Tetrachloride-Azathioprine Induced Cirrhosis and Partial Hepatectomy of Cirrhotic Liver

Acute-Phase Response in Rat to Carbon Tetrachloride-Azathioprine Induced Cirrhosis and Partial Hepatectomy of Cirrhotic Liver

Compromised Activation of Vitamin D After Elective Surgery: A Prospective Pilot Study

Effect of Laparotomy and/or Starvation on the Plasma Rapid-turnover Protein Level in Rats

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