Systemic and pulmonary responses of inflammatory cytokines following esophagectomy.

Inflammatory cytokines in plasma and bronchoalveolar lavage fluid (BALF) from 16 post-esophagectomy patients with and without preoperative methylprednisolone administration were studied. Interleukin-8 (IL-8), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) concentrations in plasma and BALF were measured by ELISA immediately after surgery (0-POD) and on the postoperative day 1 (1-POD). In patients without methylprednisolone treatment, IL-8 levels in BALF were 362 +/- 67 pg/ml on 0-POD and 948 +/- 359 pg/ml on 1-POD, and were approximately 10 times higher than those in plasma levels. IL-6 levels in plasma were significantly higher than those in BALF. The TNF-alpha concentration was similarly low in plasma and BALF. The patients with preoperative methylprednisolone treatment had significantly lower IL-8 levels in BALF and plasma compared with the patients without the treatment. Immunocytochemically, each cytokine was identified in the cytoplasm of bronchoalveolar macrophage. The percentage of polymorphonuclear cells (PMN) among BAL cells was significantly increased on 1-POD when compared with that of 0-POD, and tended to be decreased by preoperative methylprednisolone treatment. These results suggest that IL-6 was markedly increased in the peripheral circulation and that increased pulmonary IL-8 might be related to an accumulation of PMN in the lung under surgical stress. Further, methylprednisolone administration could possibly reduce postoperative cytokine responses at the local and systemic levels.

[1]  T. Yen,et al.  Perioperative plasma concentrations of tumor necrosis factor-alpha and interleukin-6 in infected patients. , 1996, Critical care medicine.

[2]  K. Inada,et al.  Methylprednisolone inhibits increase of interleukin 8 and 6 during open heart surgery , 1995, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[3]  P. Suter,et al.  Adult and paediatric size bronchoscopes for bronchoalveolar lavage in mechanically ventilated patients: yield and side effects. , 1995, Thorax.

[4]  P. Kragsbjerg,et al.  Serum concentrations of interleukin-6, tumour necrosis factor-alpha, and C-reactive protein in patients undergoing major operations. , 1995, The European journal of surgery = Acta chirurgica.

[5]  C. Haslett,et al.  Role of selectiris In development of adult respiratory distress syndrome , 1994, The Lancet.

[6]  K. Steinberg,et al.  Evolution of bronchoalveolar cell populations in the adult respiratory distress syndrome. , 1994, American journal of respiratory and critical care medicine.

[7]  H. Nagawa,et al.  Prediction of pulmonary complications after transthoracic oesophagectomy , 1994, The British journal of surgery.

[8]  T. Ishiko,et al.  Elevation of circulating interleukin 6 after surgery: factors influencing the serum level. , 1994, Cytokine.

[9]  P. Montravers,et al.  High levels of interleukin-8 in the blood and alveolar spaces of patients with pneumonia and adult respiratory distress syndrome , 1993, Infection and immunity.

[10]  J. Shelhamer,et al.  Corticosteroids differentially regulate secretion of IL-6, IL-8, and G-CSF by a human bronchial epithelial cell line. , 1993, The American journal of physiology.

[11]  R. Strieter,et al.  Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groups , 1993, The Lancet.

[12]  D. Kwiatkowski,et al.  Systemic cytokine response after major surgery , 1992, The British journal of surgery.

[13]  M. Matthay,et al.  Elevated levels of NAP-1/interleukin-8 are present in the airspaces of patients with the adult respiratory distress syndrome and are associated with increased mortality. , 1992, The American review of respiratory disease.

[14]  M. Baggiolini,et al.  Interleukin‐8, a chemotactic and inflammatory cytokine , 1992, FEBS letters.

[15]  M. Morita,et al.  Multivariate analysis of postoperative complications after esophageal resection. , 1992, The Annals of thoracic surgery.

[16]  M. Morita,et al.  Influence of preoperative treatment and surgical operation on immune function of patients with esophageal carcinoma , 1992, Journal of surgical oncology.

[17]  A. Ogata,et al.  Interleukin-6 as a new indicator of inflammatory status: detection of serum levels of interleukin-6 and C-reactive protein after surgery. , 1992, Surgery.

[18]  T. Standiford,et al.  Regulation of human alveolar macrophage- and blood monocyte-derived interleukin-8 by prostaglandin E2 and dexamethasone. , 1992, American journal of respiratory cell and molecular biology.

[19]  A. Billiau,et al.  Cytokines and their interactions with other inflammatory mediators in the pathogenesis of sepsis and septic shock , 1991, European journal of clinical investigation.

[20]  T. Standiford,et al.  Human neutrophils exhibit disparate chemotactic factor gene expression. , 1990, Biochemical and biophysical research communications.

[21]  W. Fraser,et al.  Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. , 1990, Clinical science.

[22]  A. Harken,et al.  Cytokines, sepsis and the surgeon. , 1989, Surgery, gynecology & obstetrics.

[23]  K. Matsushima,et al.  Analysis of the suppression of IL-1 alpha and IL-1 beta production in human peripheral blood mononuclear adherent cells by a glucocorticoid hormone. , 1988, Journal of immunology.

[24]  B. Shenton,et al.  The influence of surgical operations on components of the human immune system , 1985, The British journal of surgery.