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. 2011 Nov 11:8:32.
doi: 10.1186/1476-9255-8-32.

Cytokine & chemokine response in the lungs, pleural fluid and serum in thoracic surgery using one-lung ventilation

Andreas Breunig  1 , Franco Gambazzi, Beatrice Beck-Schimmer, Michael Tamm, Didier Lardinois, Daniel Oertli, Urs Zingg
Affiliations

Cytokine & chemokine response in the lungs, pleural fluid and serum in thoracic surgery using one-lung ventilation

Andreas Breunig et al. J Inflamm (Lond). .

Abstract

Background: Thoracic surgery mandates usually a one-lung ventilation (OLV) strategy with the collapse of the operated lung and ventilation of the non-operated lung. These procedures trigger a substantial inflammatory response. The aim of this study was to analyze the cytokine and chemokine reaction in both lungs, pleural space and blood in patients undergoing lung resection with OLV with special interest in the chemokine growth-regulated peptide alpha (GROα) which is the human equivalent to the rat cytokine-induced neutrophil chemoattractant-1 (CINC-1).

Methods: Broncho-alveolar lavage (BAL) fluid of both the collapsed, operated and the ventilated, non-operated lung, respectively, pleural space drainage fluid and blood was collected and the concentrations of interleukin (IL)-6, IL-1RA and GROα were determined with enzyme-linked immunosorbent assays in 15 patients.

Results: Substantial inter-individual differences in the BAL fluid between patients in cytokine and chemokine levels occurred. In the pleural fluid and the blood these inter-individual differences were less pronounced. Both sides of the lung were affected and showed a significant increase in IL-6 and IL-1RA concentrations over time but not in GROα concentrations. Except for IL-6, which increased more in the collapsed, operated lung, no difference between the collapsed, operated and the ventilated, non-operated lung occurred. In the blood, IL-6 and IL-1RA increased early, already at the end of surgery. GROα was not detectable. In the pleural fluid, both cytokine and chemokine concentrations increased by day one. The increase was significantly higher in the pleural fluid compared to the blood.

Conclusion: The inflammatory response of cytokines affects both the collapsed, operated and the ventilated, non-operated lungs. The difference in extent of response underlines the complexity of the inflammatory processes during OLV. In contrast to the cytokines, the chemokine GROα concentrations did not react in the BAL fluid or in the blood. This indicates that GROα might not be useful as marker for the inflammatory reaction in complex surgical procedures.

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Figures

Figure 1
Figure 1
Course of IL-6 in the operated collapsed and non-operated ventilated lungs in the individual 15 patients.
Figure 2
Figure 2
Course of IL-1RA in the operated collapsed and non-operated ventilated lungs in the individual 15 patients.
Figure 3
Figure 3
Course of CINC-1 in the operated collapsed and non-operated ventilated lungs in the individual 15 patients.
Figure 4
Figure 4
Course of IL-6 in the pleural fluid and blood plasma in the individual 15 patients.
See this image and copyright information in PMC

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References

    1. Sakamoto K, Arakawa H, Mita S, Ishiko T, Ikei S, Egami H, Hisano S, Ogawa M. Elevation of circulating interleukin 6 after surgery: factors influencing the serum levels. Cytokine. 1994;6:181–186. doi: 10.1016/1043-4666(94)90040-X. - DOI - PubMed
    1. Baudouin SV. Lung injury after thoracotomy. Br J Anaesth. 2003;91:132–142. doi: 10.1093/bja/aeg083. - DOI - PubMed
    1. Jordan S, Mitchell JA, Quinlan GJ, Goldstraw P, Evans TW. The pathogenesis of lung injury following pulmonary resection. Eur Respir J. 2000;15:790–799. doi: 10.1034/j.1399-3003.2000.15d26.x. - DOI - PubMed
    1. Halbertsma FJ, Vanecker M, Scheffel GJ, van der Hoeven JG. Cytokines and biotrauma in ventilator-induced lung injury: a critical reviw of the literature. Neth J Med. 2005;63:382–392. - PubMed
    1. Yim AP, Wan S, Lee TW, Arifi AA. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg. 2000;70:243–247. doi: 10.1016/S0003-4975(00)01258-3. - DOI - PubMed

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