Cytokine modifications after tension-free hernioplasty or open conventional inguinal hernia repair

Background: The purpose of this study was to evaluate the involvement of pr oinflammatory cytokines (interferon-gamma [INF-gamma], interleukin [IL]-6) and anti-inflammatory cytokines (IL-4, IL-10, IL-13) in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia (BH) repair. Methods: Thirty-five male patients (age range 25 to 60 years) with unilater al inguinal hernia without complications or recurrence were included in thi s study. Randomly, patients underwent conventional operation and had their inguinal hernia repair performed with polypropylene mesh. Peripheral venous blood samples were collected 24 hours prior to surgery and then 6, 24, 48, and 168 hours postoperatively. Fifteen healthy controls were included. Results: We present evidence that LH patients showed both an increased seru m level of Thelper 1 (Th1)-like cytokines (IFN-gamma) and an increase in Th elper 2 (Th2)-like cytokines (IL-6 and IL-10), associated with a slight red uction of peripheral blood mononuclear cells (PBMC) producing IL-6 and a no rmal level of PBMC producing IFN-T, IL-10, IL-13, and IL-4. Whereas BH pati ents showed in part an amplification of Th2-like cells, characterized by th e sustained serum production of IL-6 and IL-10, associated with an increase in IL-10 secreted by in vitro stimulated PMBC, Conclusions: Our data show that LH is associated with a higher production o f inflammatory cytokines (IFN-gamma and IL-6) compared with BH, likely indu ced by the presence of the polypropylene prostheses. (C) 2001 Excerpta Medi ca, Inc. All rights reserved.