The American Journal of Surgery
Volume 187, Issue 3 , Pages 372-377 , March 2004

Intraperitoneal cytokine response after major surgery: higher postoperative intraperitoneal versus systemic cytokine levels suggest the gastrointestinal tract as the major source of the postoperative inflammatory reaction

  • Kjell Jansson, M.D.

      Affiliations

    • Department of Surgery, Örebro University Hospital, S-701 85 Örebro, Sweden
    • Corresponding Author InformationCorresponding author. Tel.: +46-19-6021000; fax: +46-19-125439.
  • ,
  • Britt Redler, R.N.

      Affiliations

    • Department of Surgery, Örebro University Hospital, S-701 85 Örebro, Sweden
  • ,
  • Lennart Truedsson, M.D., Ph.D.

      Affiliations

    • Clinical Microbiology and Immunology Laboratory, Lund, Sweden
  • ,
  • Anders Magnuson, B.Sc.

      Affiliations

    • Centre of Clinical Research, University Hospital, Örebro, Sweden
  • ,
  • Peter Matthiessen, M.D.

      Affiliations

    • Department of Surgery, Örebro University Hospital, S-701 85 Örebro, Sweden
  • ,
  • Magnus Andersson, M.D., Ph.D.

      Affiliations

    • Department of Surgery, Örebro University Hospital, S-701 85 Örebro, Sweden
  • ,
  • Lars Norgren, M.D., Ph.D., F.R.C.S.

      Affiliations

    • Department of Surgery, Örebro University Hospital, S-701 85 Örebro, Sweden

Received 17 December 2002 ,Revised 29 May 2003

References 

  1. Landow L, Andersen LW. Splanchnic ischaemia and its role in multiple organ failure. Acta Anaesthesiol Scand. 1994;38:626–639
  2. Tamion F, Richard V, Lyoumi S, et al.  Gut ischemia and mesenteric synthesis of inflammatory cytokines after hemorrhagic or endotoxic shock. Am J Physiol. 1997;273(2 Pt 1):G314–321
  3. Welborn MB, Oldenburg HS, Hess PJ, et al.  The relationship between visceral ischemia, proinflammatory cytokines, and organ injury in patients undergoing thoracoabdominal aortic aneurysm repair. Crit Care Med. 2000;28:3191–3197
  4. Dinarello CA. Cytokines as mediators in the pathogenesis of septic shock. Curr Top Microbiol Immunol. 1996;216:133–165
  5. Yao YM, Redl H, Bahrami S, et al.  The inflammatory basis of trauma/shock-associated multiple organ failure. Inflamm Res. 1998;47:201–210
  6. Wortel CH, van Deventer SJ, Aarden LA, et al.  Interleukin-6 mediates host defense responses induced by abdominal surgery. Surgery. 1993;114:564–570
  7. Swank GM, Deitch EA. Role of the gut in multiple organ failure (bacterial translocation and permeability changes). World J Surg. 1996;20:411–417
  8. Rongione AJ, Kusske AM, Ashley SW, et al.  Interleukin-10 prevents early cytokine release in severe intraabdominal infection and sepsis. J Surg Res. 1997;70:107–112
  9. Rongione AJ, Kusske AM, Kwan K, et al.  Interleukin-10 protects against lethality of intra-abdominal infection and sepsis. J Gastrointest Surg. 2000;4:70–76
  10. Kato T, Murata A, Ishida H, et al.  Interleukin 10 reduces mortality from severe peritonitis in mice. Antimicrob Agents Chemother. 1995;39:1336–1340
  11. van Berge Henegouwen MI, van der Poll T, van Deventer SJ, et al.  Peritoneal cytokine release after elective gastrointestinal surgery and postoperative complications. Am J Surg. 1998;175:311–316
  12. Scheingraber S, Bauerfeind F, Bohme J, et al.  Limits of peritoneal cytokine measurements during abdominal lavage treatment for intraabdominal sepsis. Am J Surg. 2001;181:301–308
  13. Schein M, Wittmann DH, Holzheimer R, et al.  Hypothesis (compartmentalization of cytokines in intraabdominal infection). Surgery. 1996;119:694–700
  14. Deviere J, Le Moine O, Van Laethem JL, et al.  Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography. Gastroenterology. 2001;120:498–505
  15. Zeni F, Vindimian M, Pain P, et al.  Antiinflammatory and proinflammatory cytokines in patients with severe sepsis. J Infect Dis. 1995;172:1171–1172
  16. Rodriguez-Ramos C, Galan F, Diaz F, et al.  Expression of proinflammatory cytokines and their inhibitors during the course of spontaneous bacterial peritonitis. Dig Dis Sci. 2001;46:1668–1676
  17. Navasa M, Follo A, Filella X, et al.  Tumor necrosis factor and interleukin-6 in spontaneous bacterial peritonitis in cirrhosis (relationship with the development of renal impairment and mortality). Hepatology. 1998;27:1227–1232
  18. Zeni F, Tardy B, Vindimian M, et al.  High levels of tumor necrosis factor-alpha and interleukin-6 in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis. Clin Infect Dis. 1993;17:218–223
  19. Zeni F, Tardy B, Vindimian M, et al.  Local synthesis of tumor necrosis factor-alpha and interleukin-1 in the peritoneal cavity during spontaneous bacterial peritonitis. J Infect Dis. 1991;164:1242–1243
  20. Propst T, Propst A, Herold M, et al.  Spontaneous bacterial peritonitis is associated with high levels of interleukin-6 and its secondary mediators in ascitic fluid. Eur J Clin Invest. 1993;23:832–836
  21. Cruickshank AM, Fraser WD, Burns HJ, et al.  Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci. 1990;79:161–165
  22. Shenkin A, Fraser WD, Series J, et al.  The serum interleukin 6 response to elective surgery. Lymphokine Res. 1989;8:123–127
  23. Tsukada K, Katoh H, Shiojima M, et al.  Concentrations of cytokines in peritoneal fluid after abdominal surgery. Eur J Surg. 1993;159:475–479
  24. Baigrie RJ, Lamont PM, Kwiatkowski D, et al.  Systemic cytokine response after major surgery. Br J Surg. 1992;79:757–760
  25. Gogos CA, Drosou E, Bassaris HP, et al.  Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis (a marker for prognosis and future therapeutic options). J Infect Dis. 2000;181:176–180
  26. Fiorentino DF, Zlotnik A, Mosmann TR, et al.  IL-10 inhibits cytokine production by activated macrophages. J Immunol. 1991;147:3815–3822

PII: S0002-9610(03)00597-X

doi: 10.1016/j.amjsurg.2003.12.019

The American Journal of Surgery
Volume 187, Issue 3 , Pages 372-377 , March 2004