Changes in serum and cerebrospinal fluid cytokines in response to non-neurological surgery: an observational study.

Bromander S, Anckarsäter R, Kristiansson M, Blennow K, Zetterberg H, Anckarsäter H, Wass CE.
Journal   J Neuroinflammation.
Species  
Analytes Measured   IL-10 , IL-12 p70 , IL-13 , IL-2 , IL-4 , IL-5 , IL-8
Matrix Tested   Cerebrospinal fluid (CSF), serum
Year   2012
Volume   9
Page Numbers   242
Application   Cytokines and Chemokines
Abstract
BACKGROUND: Surgery launches an inflammatory reaction in the body, as seen through increased peripheral levels of cytokines and cortisol. However, less is known about perioperative inflammatory changes in the central nervous system (CNS). Our aim was to compare inflammatory markers in serum and cerebrospinal fluid (CSF) before and after surgery and evaluate their association with measures of blood-brain barrier (BBB) integrity.

METHODS: Thirty-five patients undergoing knee arthroplastic surgery with spinal anesthesia had CSF and serum samples drawn before, after and on the morning following surgery. Cytokines and albumin in serum and CSF and cortisol in CSF were assessed at all three points.

RESULTS: Cytokines and cortisol were significantly increased in serum and CSF after surgery (Ps <0.01) and CSF increases were greater than in serum. Ten individuals had an increased cytokine response and significantly higher CSF/serum albumin ratios (Ps <0.01), five of whom also had albumin ratios in the pathological range (>11.8). Serum and CSF levels of cytokines were unrelated, but there were strong correlations between CSF IL-2, IL-10 and IL-13, and albumin ratios (Ps <0.05) following surgery.

CONCLUSION: Cytokine increases in the CNS were substantially greater than in serum, indicating that the CNS inflammatory system is activated during peripheral surgery and may be regulated separately from that in the peripheral body. CSF cytoki ne increase may indicate sensitivity to trauma and is linked to BBB macromolecular permeability.

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