ABNORMAL CYTOKINE SERUM LEVELS CORRELATE WITH IMPAIRED CELLULAR IMMUNE-RESPONSES AFTER SURGERY

Serum levels of the interleukins (IL)-2, -1 beta, and -6, tumor-necros is factor alpha (TNF-alpha), and prostaglandine E2 (PGE2) were measure d serially before and after operation in patients undergoing various s urgical procedures. Peripheral blood mononuclear cells (PBMC) from the same patients were analyzed before and after surgery for proliferativ e responses in the autologous mixed lymphocyte reaction (AMLR) and for cytolytic activity against the natural killer (NK)-sensitive K562 cel l line. In patients who had major surgery, a decrease in IL-2 levels a nd increases in IL-1 beta, TNF-alpha, IL-6, and PGE2 levels were obser ved up to 9 days after the operation compared to those of the preopera tive values. Decreased AMLR responses and NK activity were also observ ed in PBMC collected 5 days after surgery. All these changes were more intense in patients who had undergone major surgical procedures of in creasing severity (i.e., cancer patients). Similar, although weaker, c hanges in cytokine serum levels, AMLR responses, and NK activity were also observed in patients undergoing minor surgery. Our data suggest t hat changes in cytokine serum levels may cause cellular immune dysfunc tions, particularly in patients undergoing major surgery, and provide the basis for immune intervention in order to avoid infections occurri ng after major surgery. (C) 1994 Academic Press, Inc.