Cytokines and acute-phase response markers derangements in patients with obstructive jaundice

Background/Aims: Prolonged acute-phase response and increase of cytokines h ave been associated with higher mortality and surgical complications. This study investigated the status of cytokines and acute-phase response markers in patients with Obstructive jaundice. Methodology: Forty-one patients were investigated Endotoxin, tumor necrosis factor-g interleukin-6, nitric oxide, C-reactive protein, liver enzymes, a lbumin and percentage of weight loss were determined at admission. Results: Endotoxin, interleukin-6 and C-reactive protein were significantly elevated in both benign and malignant obstructive jaundice. Increased plas ma levels of tumor necrosis factor-a were only detected in malignant tumors (68 us. 24pg/mL; P < 0.001). Patients with positive acute-phase response ( C-reactive protein > mean + 2 SD of controls) had greater weight loss (P = 0.02), endotoxin (P = 0.03) and interleukin-6 plasma levels (P = 0.05) than those with no inflammatory response. Prolonged biliary obstruction (> 10 d ays) was associated with higher weight loss (P = 0.04), tumor necrosis fact or-alpha (P = 0.003) and interleukin-6 (P = 0.05) plasma levels. Conclusions: A prolonged high-grade biliary tract obstruction prompted an i ncrease in endotoxin levels, associated with a positive acute-phase respons e and cytokine elevation.