Abstract
To determine the role of cytokines in the host defense in surgical patients, we investigated the kinetics ofpost-operative elevation of cytokines and factors influencing the increase in serum IL-6 concentration in 38 patientswho underwent elective surgery. Serum IL-6 levels reached the maximum on the 1st post-operativeday in allpatients. Concentrations of IL-6 and IL-8 in the drain exudate were significantly higher than those in the peripheralblood. Strong expression of m RNAs of IL-6 and IL-8 was observed in the leukocytes in the exudate of the thorax andabdomen during the operative and 1st and 2nd post-operative days. On the otherhand, there was little expression ofthese mRNAs in the peripheral leukocytes. Significant correlations were observed between peak serum values of IL-6 and operation time or volume of blood loss during surgery. These results suggest that (1) cytokines are mainlyinduced and produced in the operative field and subsequently spill over into the blood, inducing hypercytokinemia, and (2) operation time and volume of blood loss during surgery are factors influencing the production ofcytokines.
