Effect of Abdominal Infections on Peritoneal and Systemic Production of Interleukin 6 and Monocyte Chemoattractant Protein-1

Abstract

The aim of the study was to compare peritoneal and systemic production of interleukin 6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) in uninfected patients and in patients with peritonitis. Peritoneum was excised at laparotomy for acute peritonitis (n = 22) or noninfectious reasons (n = 61), and was incubated with or without lipopolysaccharide (LPS). Mediator concentrations in the culture-supernatants, in the patients' serum, and in plasmasupernatants of LPS-stimulated whole blood were related to outcome. Spontaneous production of IL-6 by the peritoneum was increased in infected patients compared with uninfected patients. In contrast to IL-6, LPS-stimulated production of MCP-1 was significantly less in infected patients. Serum concentrations of both mediators were higher in infected patients and the highest concentrations of MCP-1 were in patients who died. LPS-stimulated production of IL-6 in whole blood was least, whereas that of MCP-1 was greatest in infected patients who died. These contrasting results for local and systemic production of mediators illustrate the compartmentalized immune response to intra-abdominal infection.

A Prospective Case-Control Study of the Local and Systemic Cytokine Response After Laparoscopic Versus Open Colonic Surgery

“…As can be seen in this study, plasma cytokine concentrations were much lower than peritoneal concentrations. This has been noted in several earlier publications and is thought to be due to incomplete absorption into the portal circulation, hepatic metabolism, and dilution in plasma, causing an apparent independence of the peritoneal response from the systemic one [21,56,73].…”

Endotoxin-induced gene expression differences in the brain and effects of iNOS inhibition and norepinephrine

“…The Ccl2 (macrophage chemoattractant protein-1, MCP-1) serum level in acute peritonitis was greatest in patients who died [27]. Consistently, patients with severe forms of sepsis revealed highest Ccl2 plasma levels [28].…”

Organ dysfunction and long term outcome in secondary peritonitis

“…A systemic expression of pro-and antiinflammatory mediators occur, and detrimental effects on organ function may ensue via changes in microcirculation and/or cellular utilization of oxygen [21][22][23].…”