POSTOPERATIVE CHANGES IN SERUM INTERLEUKIN-2 CONCENTRATIONS

Objective: To evaluate the postoperative changes in circulating interl eukin-2 (IL-2) concentration according to the severity of the surgical injury and other postoperative variables that could influence IL-2 pr oduction. Design: Prospective observational study. Setting: University hospital, Italy. Subjects: 43 patients about to undergo major operati ons (gastric and cole-rectal resection for cancer), intermediate opera tions (open cholecystectomy or mastectomy for cancer), and minor opera tions (hernia repair or breast lump); 24 healthy age and sex matched c ontrols. Main outcome measures: Postoperative changes in serum concent rations of IL-2 after different degrees of surgery on the 1(st), 3(rd) and 8(th) postoperative days correlated with changes in in vivo cellu lar mediated immunity (skin tests), duration of operation, blood trans fusion or postoperative H-2-blockers and antiprostaglandins. Results: There were no significant variations in IL-2 serum concentrations post operatively on ANOVA, and when the data were normalised, there were no significant changes in the median postoperative values after minor an d intermediate operations. There was a slight but not significant incr ease in IL-2 concentrations after major operations. Neither blood tran sfusion nor duration of operation correlated with postoperative change s in IL-2, while postoperative antiprostaglandins and H-2-blockers see med to provide slight but not significant protection against a reducti on in IL-2 concentrations. Conclusions: Circulating IL-2 does not nece ssarily correlate with reported in vitro postoperative production of I L-2 and therefore seems to be of little use in monitoring immunosuppre ssion in surgical patients.