Abstract
The body’s defense mechanism in response to stress may appear to be the sum of activation and suppression. We investigated chronological changes in tumor necrosis factor-α (TNF-α) production by local effusion cells and whole blood of esophageal cancer patients who had undergone radical resection. Whole blood, pleural effusion cells, and bronchoalveolar lavage fluid (BALF) cells were obtained from the 20 patients. Whole blood was stimulated withEscherichia coli (1μg/ml),Staphylococcus aureus (10μg/ml), and lipopolysaccharide (LPS) (1μg/ml), and pleural effusion cells and BALF cells were stimulated with LPS; 24-H incubation and TNF-α concentration in supernate was measured by enzyme-linked immunosorbent assay (ELISA). Within 3h after starting the operation, TNF-α production in whole blood was significantly (P<0.05) decreased compared with preoperative value by each stimulation, and this suppression persisted up to day 3. These reductions in postoperative TNF-α production correlated with intraoperative hemorrhage. On the other hand, the LPS-induced release of TNF-α into pleural effusion cells and BALF cells were markedly increased during the study period. These results indicate that large quantities of cytokines are produced by a second attack, such as infection, in areas where immunocytes accumulate. We believe that the body reacts to surgical stress in a variety of ways. Circulating blood and immunocytes that accumulate in damaged organs are thought to react very differently to stress.
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Bone RC (1991) The pathogenesis of sepsis. Ann Intern Med 115:457–469
Endo S, Inada K, Cheska M, Takakuwa T, Yamada Y, Nakae H, Kasai T, Yamashita H, Taki K, Yoshida M (1995) Plasma interleukin 8 and polymorphonuclear leukocyte elastase concentrations in patients with septic shock. J Inflamm 45:136–142
Wakabayashi G, Gelfand JA, Jung WK, Connolly RJ, Burke JF, Dinarello CA (1991)Staphylococcus epidermidis induces complement activation, tumor necrosis factor and interleukin-1, a shocklike state and tissue injury in rabbits without endotoxenia. Comparison toEscherichia coli. J Clin Invest 87:1925–1935
Sato N, Murakami K, Ishida K, Ikeda K, Saito K (1991) Pulmonary hypertension and polymorphonuclear leukocyte elastase after esophageal cancer operation. Ann Thorac Surg 51:754–758
Steven M (1997) Confirmatory interleukin-1 receptor antagonist trial in severe sepsis: a phase III, randomized, double-blind, placebo-controlled, multicenter trial. Crit Care Med 27:1115–1123
Bone RC (1996) Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: what we do and do not know about cytokine regulation. Crit Care Med 24: 163–172
Fisher CJ Jr, Dhainaut JF, Opal SM (1994) Recombinant human interleukin-1 receptor antagonist in the treatment of patients with sepsis syndrome; results from a randomized, double-blind, placebo-controlled trial. JAMA 271:1836–1843
Sato N, Koeda K, Ikeda K, Ohtuka K, Kimura Y, Ishida K, Saito K (1997) Effect of preoperative methylpredonisolone infusion on stress response in patients undergoing esophageal cancer surgery (in Japanese with English abstract). Nippon Shoukaki Gekagakki Zasshi (Jpn J Gastroenterol Surg) 30:1831–1838
Ogawa M (1996) Mechanisms of the development of organ failure following surgical insult: the “second attack” theory. Clin Intens Care 7:34–38
Borrelli E, Roux-Lombard P, Grau GE, Girardin E, Ricou B, Dayer J, Suter PM (1996) Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk. Crit Care Med 24:392–397
Froon AH, Bemelmans MH, Greve JW, van der Linden CJ, Buurman WA (1994) Increased plasma concentration of soluble tumor necrosis factor receptors in sepsis syndrome; correlation with plasma creatinine values. Crit Care Med 22:803–809
Fischer E, Van Zee KJ, Marano MA, Rock CS, Kenney JS, Poutsiaka DD, Dinarello CA, Lowry SF, Moldawer LL (1992) Interleukin-1 receptor antagonist circulates in experimental inflammation and in human disease. Blood 79:2196–2200
Bone RC (1996) Sir Isaac Newton, sepsis, SIRS, and CARS. Crit Care Med 24:1125–1128
Members of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee (1992) American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874
Greisman SE (1976) In: Beers RF, et al. (eds) The role of immunological factors in infections, allergic and autoimmune processes. Raven, New York, pp 43–50
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This work was supported in part by the special research grants for the development of characteristic education by Japan Private School Promotion Foundation (Nippon Shigaku Shinko Zaidan)
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Kimura, Y., Yaegashi, Y. & Sato, N. Tumor necrosis factor-α production after esophageal cancer surgery: Differences in the response to lipopolysaccharide stimulation among whole blood, pleural effusion cells, and bronchoalveolar lavage fluid cells. Surg Today 29, 10–15 (1999). https://doi.org/10.1007/BF02482963
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DOI: https://doi.org/10.1007/BF02482963