Cytokines and acute-phase response markers derangements in patients with obstructive jaundice
Padillo, F.J.; Andicoberry, B.; Muntane, J.; Lozano, J.M.; Miño, G.; Sitges-Serra, A.; Solorzano, G.; Pera-Madrazo, C.
Hepato-Gastroenterology 48(38): 378-381
2001
ISSN/ISBN: 0172-6390 PMID: 11379313 Document Number: 536127
Background/Aims: Prolonged acute-phase response and increase of cytokines have been associated with higher mortality and surgical complications. This study investigated the status of cytokines and acute-phase response markers in patients with obstructive jaundice. Methodology: Forty-one patients were investigated. Endotoxin, tumor necrosis factor-alpha, interleukin-6, nitric oxide, C-reactive protein, liver enzymes, albumin and percentage of weight loss were determined at admission. Results: Endotoxin, interleukin-6 and C-reactive protein were significantly elevated in both benign and malignant obstructive jaundice. Increased plasma levels of tumor necrosis factor-alpha were only detected in malignant tumors (68 vs. 24pg/mL; P<0.001). Patients with positive acute-phase response (C-reactive protein > mean + 2 SD of controls) had greater weight loss (P=0.02), endotoxin (P=0.03) and interleukin-6 plasma levels (P=0.05) than those with no inflammatory response. Prolonged biliary obstruction (> 10 days) was associated with higher weight loss (P=0.04), tumor necrosis factor-alpha (P=0.003) and interleukin-6 (P=0.05) plasma levels. Conclusions: A prolonged high-grade biliary tract obstruction prompted an increase in endotoxin levels, associated with a positive acute-phase response and cytokine elevation.