BLOOD CYTOKINE LEVELS RISE EVEN AFTER MINOR SURGICAL TRAUMA

The exact changes in cytokine production and clinical implications of the increased cytokine levels following operative trauma remain unclea r. In this study, systemic production of a spectrum of cytokines, incl uding IL1 alpha, IL1 beta, IL6, IL8, IL10, and IFN gamma, was examined in patients undergoing minor elective operative trauma. The levels of IL1 receptor antagonist (ra) and IL6 soluble receptor (sR) were also determined. Although there were no changes in IL1 alpha and IL1 beta p lasma levels during the entire observation period, there was a signifi cant rise in IL1, ra level in all patients between postoperative day 1 and postoperative day 14. A significant increase in the IL6 plasma le vel was seen on days 1, 3, and 7 after surgery and an increase in the IL6 sR level was observed on postoperative days 10 and 14. Interesting ly, the IL8 plasma values had risen significantly on days 1 and 3 foll owing the operation. In some patients, an elevation in IL10 plasma lev el was noted on days 1 and 3 postsurgery. Results demonstrated that ev en a minor surgical procedure such as cholecystectomy with uneventful wound healing was followed by an appearance in the blood circulation o f significant levels of cytokines between day 1 and day 14 after surge ry. These observations point to the necessity of searching for methods of down-regulating the systemic cytokine effects after surgical traum a for the routine postoperative management.