Increase in lactoferrin and elastase alpha-1-proteinase inhibitor complexes but lack of complement activation and IL-6 response following thoracic surgery.

Abstract

Polymorphonuclear neutrophil (PMN) stimulation and degranulation can be mediated by the cytokines and by complement activation. The aim of the present study was to measure TNF alpha, IL-1 alpha, IL-6 and C3d in relation to postoperative increase in lactoferrin and elastase alpha-1-proteinase inhibitor (E alpha-1-PI) levels. Eleven patients undergoing thoracic surgery took part in the study. Blood leucocytes, E alpha-1-PI, lactoferrin and C3d were measured preoperatively, at the end of surgery and postoperatively, at 4 h and on day 1, 2, 3 and 5. TNF alpha, IL-1 alpha and IL-6 were measured preoperatively, at the end of surgery and postoperatively, at 4 h, and on days 1 and 5. The leucocyte count, lactoferrin and E alpha-1-PI levels increased significantly postoperatively (P < 0.01). There was no significant change in C3d values. Plasma IL-6 levels were unchanged in the postoperative period. Plasma TNF alpha and IL-1 alpha were detectable at low levels in only two and four patients, respectively. The postoperative increase in blood levels of PMN lactoferrin and E alpha-1-PI complexes observed in the present study was not accompanied by complement activation, or increased blood levels of IL-6.