Complement activation and release of interleukin-6 and tumour necrosis factor-α in drained and systemic blood after major orthopaedic surgery

Krohn, Claus Danckert; Reikerås, Olav; Mollnes, Tom Eirik; Aasen, Ansgar O.

doi:10.1080/110241598750004742

Cited by 27 publications

(14 citation statements)

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“…There was also no correlation with body mass index, comorbidity, surgical time, or complications of UTI, URTI, lower respiratory tract infection, or DVT. Autologous blood obtained from cell salvage systems also is associated with higher levels of IL-6 [1,20]. None of our patients had retransfusion of autologous blood.…”

Section: Discussionmentioning

confidence: 86%

Circulating Cytokines after Hip and Knee Arthroplasty: A Preliminary Study

Shah

Aslam

Patil

et al. 2008

Clin Orthop Relat Res

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Section: Discussionmentioning

confidence: 86%

Circulating Cytokines after Hip and Knee Arthroplasty: A Preliminary Study

Shah

Aslam

Patil

et al. 2008

Clin Orthop Relat Res

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“…Recent studies have demonstrated that elective orthopedic surgery significantly elevates serum levels of interleukin-6 (IL-6) [1,5,7,10,11,13,16,[18][19]; in these circumstances, IL-6 rises rapidly in serum after the incision, peaking at 8-24 h. This increase has been attributed to the release of IL-6 from immunocompetent cells in the wound region [13,16], and it was found to significantly correlate with surgical trauma as defined by operation length and the volume of blood loss during surgery [13].…”

Section: Introductionmentioning

confidence: 99%

Serum interleukin-6 response to elective total hip replacement surgery

Minetto

Oprandi

Saba

et al. 2006

International Orthopaedics (SICO

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The focus of this work was to study the serum interleukin-6 (IL-6) response to total hip replacement. Twenty-one patients received an uncemented total hip prosthesis. Venous samples for IL-6 determination were drawn before and after surgery. The IL-6 response was significant, and a peculiar heterogeneity of response was apparent: the medians of peak levels (82.3 pg/ml) and of areas under the response curve (51.8 pg/ml) distinguished between IL-6 high responders (HR) and IL-6 low responders (LR; p<0.0001). No difference was found in the gender composition of these groups, whereas the HR patients were older than the LR patients (p<0.05). The amount of IL-6 increase was found to correlate with patient age, whereas its slope was found to correlate with the duration of the surgical procedure. Moreover, the HR group presented a higher degree of hyperthermia in the days after surgery compared with the LR patients, without evidence of differences in postoperative complications, time to mobilisation, or length of stay in hospital. The main finding of our study was the evidence of a remarkable variability between individuals in the IL-6 response to surgery. Future studies are needed to identify the factors involved in the regulation of the cytokine response to surgery.

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“…In another related study, no evidence was found for complement activation by classic or alternative pathway in hip replacement surgery [12].High levels of complement activation are recorded in blood samples taken from the drainage device immediately after operation for repair of thoracic scoliosis. Local activation of the complement was found to be 10 times greater than that in general systemic circulation [13].…”

Section: Resultsmentioning

confidence: 98%

Complement activation following cholecystectomy and the effect of gallstones in bile complement

et al. 2010

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Objective: This study was scheduled in an attempt to detect the complement activation following abdominal operations of medium severity with uneventful postoperative course, and the possible effect of gallstones in bile complement. Method: Seventeen patients with cholelithiasis (mean age 58.1 years) were studied after undergoing elective open cholecystectomy. Blood samples were obtained before and immediately after the operation as well as on postoperative days 1, 2, 4 and 5. Complement activation was also measured in bile collected intraoperatively from ten patients (mean age 63.7 years range 47-79) submitted to elective cholecystectomy for cholelithiasis. Bile was also collected intraoperatively from ten other patients (mean age 66.2 years, range 51-78) who were operated electively for benign disease. This bile was incubated with gallstones and complement activation was measured before, immediately after, and at the 30min, 1h and 2h of incubation. Twenty-seven apparently healthy individuals (mean age 41.9 years) were used as controls. Results: (a) Among the complement activation products, only C4d presented a statistically significant postoperative variation (p<0.005) with a peak value between the 1st and 4th postoperative day. (b) C3adesArg and SC5b-9 concentrations were significantly higher in all samples than those of the controls. (c) C3 and C4 levels varied in accordance with the postoperative acute phase reaction as reflected by the CRP values. (d) The levels of all activation products measured in the bile of patients with cholelithiasis were significantly higher than those detected in the bile of patients with benign disease (p<0.005). (e) There was also a great increase in the levels of these products in the bile incubated with gallstones. Conclusions: The uneventful postoperative course following abdominal operations of medium severity is accompanied by a low level activation of the classical complement pathway, and the above results indicate that the presence of gallstones may activate serum complement system directly. Gallstones cause activation of bile complement in vivo. Furthermore, they cause an in vitro activation of bile complement. The in vivo activation of bile complement in the presence of gallstones indicates that they exert a direct effect on the final evolution of the in situ processes Material and MethodsOur study series comprised 17 patients (15 women, 2 men, aged 58,1 +/-5,2 years old who underwent open cholecystectomy for cholelithiasis with an un-

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Complement activation and release of interleukin-6 and tumour necrosis factor-α in drained and systemic blood after major orthopaedic surgery

Abstract: Complement activation and IL-6 release after surgical trauma differ significantly in local and systemic blood samples. Conclusions based only on systemic findings may be limited.

Cited by 27 publications

References 0 publications

Circulating Cytokines after Hip and Knee Arthroplasty: A Preliminary Study

Circulating Cytokines after Hip and Knee Arthroplasty: A Preliminary Study

Serum interleukin-6 response to elective total hip replacement surgery

Complement activation following cholecystectomy and the effect of gallstones in bile complement

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