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首页> 外文期刊>Cytokine >Depression of plasma levels of cytokines and ex-vivo cytokine production in relation to the activity of the pituitary-adrenal axis, in patients undergoing major vascular surgery.
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Depression of plasma levels of cytokines and ex-vivo cytokine production in relation to the activity of the pituitary-adrenal axis, in patients undergoing major vascular surgery.

机译：在进行大血管手术的患者中，与垂体-肾上腺轴活性相关的血浆细胞因子水平降低和离体细胞因子产生。

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The relation between the immune and neuroendocrine response during surgery was studied. In 18 patients undergoing major vascular surgery, circulating interleukin (IL)-1beta and ex-vivo production of IL-1beta and tumour necrosis factor (TNF)-alpha were lower on day 1 after surgery compared to pre-operation values (-14+/-5%, P<0.05; -62+/-9%, P<0.05; and -31+/-54%, P<0.005, respectively). Circulating IL-1 receptor antagonist (IL-1ra) was higher on the 5th day post-operatively compared to pre-operation values (mean +640%+/-400, P<0.05).In a more detailed study in six patients, the ex-vivo production of IL-1beta and TNF-alpha started to decrease at induction of general anaesthesia and dropped to under 10% of initial values at the end of surgery. Circulating IL-1ra and ex-vivo production of IL-1ra started to increase at the end of surgery and remained elevated up to 6 days post-operatively. Plasma antidiuretic hormone (ADH) and adrenocorticotropic hormone (ACTH) increased during surgery, but cortisol remained unchanged.We demonstrate a depression of circulating pro-inflammatory IL-1beta and an increase of circulating anti-inflammatory IL-1ra during surgical stress. The ex-vivo production of IL-1beta and TNF-alpha was suppressed, indicating a downregulation of the production of these cytokines. This parallelled the hormonal reaction with high ADH and ACTH, but not of cortisol, suggesting that glucocorticoid is not the key-factor in downregulation of production and release of pro-inflammatory cytokines. Copyright 1999 Academic Press.
机译：研究了手术过程中免疫反应与神经内分泌反应之间的关系。在18例接受大血管手术的患者中，与手术前相比，术后第一天的循环白细胞介素（IL）-1beta和离体产生的IL-1beta和肿瘤坏死因子（TNF）-α较低（-14+ -5％，P <0.05; -62 +/- 9％，P <0.05;和-31 +/- 54％，P <0.005）。术后第5天循环IL-1受体拮抗剂（IL-1ra）高于术前值（平均值+640％+ /-400，P <0.05）。在对6位患者的更详细研究中， IL-1β和TNF-α的离体产生在全麻诱导下开始降低，并在手术结束时降至初始值的10％以下。手术结束时循环中的IL-1ra和离体产生的IL-1ra开始增加，并在术后6天一直保持升高。血浆抗利尿激素（ADH）和促肾上腺皮质激素（ACTH）在手术过程中增加，但皮质醇保持不变。我们证明在手术压力下循环促炎性IL-1β降低，循环消炎性IL-1ra升高。 IL-1β和TNF-α的离体生产受到抑制，表明这些细胞因子的生产下调。这使激素反应与高水平的ADH和ACTH平行，但与皮质醇的水平不平行，这表明糖皮质激素不是促炎性细胞因子产生和释放下调的关键因素。版权所有1999，学术出版社。

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