, Volume 13, Issue 5, pp 442-449

Type-2 dominant cytokine gene expression following hepatic surgery

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Abstract

Background/Purpose

Hemorrhage and ischemic liver injuries associated with hepatic resection are thought to play a role in postoperative complications, possibly through altered cytokine production. The current study was performed to investigate the effects of hepatectomy on cytokine gene expression.

Methods

We collected blood preoperatively, at completion of operation, and on postoperative days 1 and 5 from ten patients undergoing hepatic resection. The peripheral blood mononuclear cells were evaluated with real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) for gene expression of interleukin-10 (IL-10), proinflammatory cytokines (interferon-γ [IFNγ], IL-15, tumor necrosis factor α [TNFα], and chemokines regulated on activation, normal T expressed and secreted [RANTES], macrophage inflammatory protein 1 alpha [MIP-1α], [MIP-1β]). Wilcoxon Rank and paired t-tests were used for statistical analysis.

Results

Immediately following hepatectomy there was a significant (31.4 ± 60.5-fold; P < 0.05) increase in IL-10 gene expression that was sustained until the first postoperative day. In contrast, there was a significant downregulation (38 ± 71 eight fold lower than preoperative; P < 0.05) of IFNγ gene expression on day 1. By postoperative day 5, the changes in gene transcript levels of both IL-10 and IFNγ had returned to the preoperative baselines. This contrasting change in IL-10 and IFNγ gene expression in response to hepatic resection was statistically significant (P = 0.02).

Conclusions

Hepatectomy elicits an imbalance towards the immunosuppressive type-2 cytokine profile in the early postoperative period. Measurement of cytokine gene transcripts following hepatic resection may have predictive value for clinical outcome, and deserves further study.