Different responses to surgical stress between extra domain A+ and plasma fibronectins

1. Fibronectins (FN) are believed to have a role in haemorheological pertur bation associated with tissue damage. Fibronectins exist in two antigenical ly related forms, plasma (p) and cellular fibronectin, which has the extra domain sequences A (EDA) or B (EDB), The present study was designed to dete rmine changes in plasma p-FN and EDA + FN under different types of surgical stress. 2, Sixty-two patients were divided into three groups: (i) group A, 33 patie nts undergoing hepato-pancreato-biliary surgery; (ii) group B, 19 patients undergoing laparoscopic cholecystectomy; and (iii) group C, 10 patients wit h postoperative complications. Plasma FN and EDA + FN levels were measured in these patients undergoing different types of surgical operation and eith er with or without liver cirrhosis using an enzyme-linked immunosorbent ass ay. 3, After surgery, a significant decrease in p-FN levels and a significant i ncrease in EDA + FN levels was observed in all patient groups compared with pre-operative levels. The duration of increased EDA + FN levels, but not p -FN levels, in group A patients was significantly longer than in group B pa tients. Although changes in p-FN levels between patients with and without l iver cirrhosis were significantly different, there were no significant diff erences in the EDA + FN levels between these two patient groups, 4, In conclusion, EDA + FN and p-FN levels were found to exhibit opposite r esponses to surgical stress. Furthermore, with greater surgical stress, gre ater increases in FDA + FN levels were seen. The presence of liver cirrhosi s had no significant effect on EDA + FN levels during the perioperative per iod; however, p-FN levels were significantly affected. 5, Thus, it is suggested that plasma EDA + FN levels reflect the magnitude of surgical stress more closely than do p-FN levels.