The cytokines IL-1β and IL-1 receptor antagonist, IL-2 and IL-2 soluble receptor-α, IL-6 and IL-6 soluble receptor, TNF-α and TNF soluble receptor I, and IL10 in drained and systemic blood after major orthopaedic surgery

Abstract

Objective

To measure the concentration of the cytokines interleukin-1β (IL-1β), interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumour necrosis factor-α (TNF-α) and the modulators of their function interleukin-1 receptor antagonist (IL-1Ra), interleukin-2 soluble receptor alpha (IL-2 sRα), interleukin-6 soluble receptor (IL-6sR) and soluble tumour necrosis factor receptor I (sTNFR-I) in systemic and drained blood for the first six hours after a major orthopaedic operation.

Design

Prospective study.

Setting

University hospital, Oslo.

Patients

8 patients operated on for thoracic scoliosis.

Main outcome measure

Concentrations of IL-1β, IL-2, IL-6, IL-10, TNF-α, IL-1Ra, IL-2 sRα, IL-6sR, and sTNFR-I were measured together with haemoglobin (Hb) concentration, white cell count (WCC), and differential count in arterial and drained blood at wound closure and 1, 2, 4, and 6 hours postoperatively.

Results

IL-1β and IL-6 concentrations increased significantly in drained blood, whereas that of TNF-α increased only in arterial blood. The modulating factors IL-1Ra, sTNFR-I, and IL-10 were increased both in arterial and drained blood. IL-6sR had decreased slightly at 6 hours in drained blood. No IL-2 was found and IL-2 sRα decreased simultaneously with the haemodilution. In arterial blood there was a granulocytosis and in drained blood a relative lymphocytosis.

Conclusion

Cytokine responses to surgical trauma include modulating factors such as soluble receptors and receptor antagonists that have different responses systemically and locally.

cytokines, cytokine receptors, orthopaedic surgery, autologous transfusion, drained blood