[Alteration of serum interleukin-1 receptor antagonist and interleukin-6 levels after surgical injury].

The aim of the study was to investigate alterations in systemic production of interleukin 1 receptor antagonist (IL-1Ra) and interleukin 6 (IL-6) following major abdominal surgery in oncologic patients and in patients after minor surgical trauma who had undergone open cholecystectomy (OC). Studies were carried out in 30 patients. The concentrations of IL-1Ra in oncologic patients (865 +/- 1021 pg/ml) before operation were significantly higher (p = 0.042) in comparison with OC group (466.16 +/- 389 pg/ml). There was a significant (p = 0.017) increase in the IL-1Ra level to 2735 +/- 1943 pg/ml on day 1 after major surgery and the IL-1Ra level remained significantly elevated until the day 10. The IL-1Ra values were significantly increased on day 1 after OC (843.93 +/- 627 pg/ml, p = 0.001) and remained significantly (p = 0.02) elevated until the 10 postoperative day. The IL-1Ra serum concentrations were significantly higher on day 1 to 10 after major surgery with complications compared with patients after OC and uneventful postoperative course. The preoperative concentrations of IL-6 in oncologic patients was 24.9 +/- 64 pg/ml and in OC patients 8.35 +/- 14 pg/ml. The level of IL-6 on the day 1 after the major operations was ten times higher (268.38 +/- 330 pg/ml, p = 0.002) and remained significantly elevated over the ten days period. The highest concentration of IL-6 was observed in oncologic patients with severe complications (384.7 +/- 484 pg/ml). The significantly lower level of IL-6 (p = 0.009) was seen after OC in patients with uneventful postoperative course (50.6 +/- 53 pg/ml on the 1st postoperative day) as compared to major surgery. We conclude that elevated serum concentrations of IL-1Ra and IL-6 on the day 1 following surgery represent early sensitive markers of the extent of surgical trauma. The monitoring of changes in IL-1Ra and IL-6 blood levels may be useful in early recognising of pathological response to surgical trauma in oncologic patients after major surgery with increased risk of the development severe complications.