The role of interleukin-6, interleukin-16, tumor necrosis factor-alpha and endotoxin in hepatic resection

Abstract

Background/aims: The role of cytokines was investigated in patients undergoing hepatic resection.

Materials and methods: Cytokines such as interleukin-16, interleukin-6 and tumor necrosis factor-alpha were serially measured both before and after hepatic resection.

Results: The levels of interleukin-16 and interleukin-6 increased immediately after operation, while that of tumor necrosis factor-alpha was only slightly elevated. The increase in interleukin-6 was more prominent than that in interleukin-16. The level of urinary polyamine was elevated at postoperative day 1, while the level of C-reactive protein reached a peak at postoperative day 3. Moreover, no endotoxin in either the peripheral or portal vein was ever detected in this series. Regarding the comparison between major (more than 2 segments) and minor (less than 1 segment) resections, no significant difference was found in the levels of interleukin-1 beta, interleukin-6 or urinary polyamine.

Conclusions: Therefore, interleukin-6 is considered to be a more sensitive marker of surgical stress than interleukin-1 beta and CRP, while both interleukin-6 and interleukin-16 are suggested to induce hepatic regeneration and the production of acute phase protein in the liver. Furthermore, the absence of any correlation between the volume resected and those cytokine levels suggests that some other as yet unidentified mechanism could be also related to the regulation of hepatic regeneration.