Increases in soluble tumor necrosis factor receptors coincide with increases in interleukin-6 and proteinases after major surgery.

BACKGROUND/AIMS: To determine whether increases in soluble tumor necrosis factor receptors (sTNFRs) are associated with the levels of cytokines and proteinases in patients undergoing major surgery.

METHODOLOGY

Eleven patients who underwent esophagectomy for squamous cell carcinoma of the thoracic esophagus were studied. The circulating blood concentrations of interleukin-6 (IL-6), IL-8, sTNF-R55, sTNF-R75, elastase/al-proteinase inhibitor complex (elastase) and matrix metalloproteinase-9 (MMP-9) were measured by ELISA or EIA before surgery, just after surgery, and on postoperative days (POD) 1 and 3.

RESULTS

The levels of serum IL-6, plasma IL-8, plasma elastase and plasma MMP-9 increased significantly after surgery, peaking just after surgery or on POD 1 and then declining. In contrast, the serum levels of sTNFRs increased approximately 2-fold just after surgery compared with the preoperative values and then remained elevated. The IL-6 level correlated with the levels of sTNF-R55 and sTNF-R75 after surgery.

CONCLUSIONS

These results suggest that increases of IL-6, serine proteinases and MMPs may be involved in the upregulation of sTNFRs in patients undergoing major surgery.