Ge. Curtis et al., THE EFFECT OF NUTRITIONAL-STATUS ON THE CYTOKINE AND ACUTE-PHASE PROTEIN RESPONSES TO ELECTIVE SURGERY, Cytokine, 7(4), 1995, pp. 380-388
Weight loss and impaired nutritional status are associated with increa
sed complications following surgery This study aimed to assess the eff
ect of nutritional status on the magnitude of the acute phase protein
response, and determine if this is associated,vith changes in the magn
itude of the related cytokine responses. Nineteen patients (10 well no
urished, 9 malnourished on the basis of body composition) undergoing m
ajor abdominal surgery were studied by frequent blood sampling in the
early postoperative period. There was a significant reduction iu the p
lasma C- reactive protein response in the malnourished group, but no d
ifference between the groups in the responses of alpha(1)-antitrypsin,
alpha(1)-acid glycoprotein, or in the trace elements iron or zinc, wh
ich reflect induction of ferritin and metallothionein. There was an ea
rly increase in IL-6, soluble receptors of TNF, and in IL-1 receptor a
ntagonist in both groups, but no detectable increase in plasma IL-1 or
TMF. There was no difference between the wellnourished and malnourish
ed group for any of these markers of activation of the cytokine networ
k. Weight loss is therefore associated with a reduction in aspects of
the acute phase response, but this is due to impaired effectiveness ra
ther than reduced magnitude of the cytokine response.