Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix

Fernando A. Rivera-Chavez, Herbert Wheeler, Guy Lindberg, Robert S. Munford, Grant E. O'Keefe

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Objective: To measure local (peritoneal fluid) and systemic (plasma) cytokine profiles in patients with infection-inflammation of the vermiform appendix, a relatively mild, localized inflammatory process. Summary Background Data: The systemic host response to invading microorganisms, often termed the systemic inflammatory response syndrome (SIRS), includes changes in heart rate, respiratory rate, body temperature, and circulating white blood cell numbers. Although these changes can be induced experimentally by administering proinflammatory cytokines, the mediators that appear in the bloodstream during early, localized infection in humans have not been defined. Methods: The authors studied 56 patients with pathologically proven appendicitis. Blood was obtained before the induction of anesthesia, when 82% of the patients met the criteria for SIRS. Peritoneal fluid (PF) was obtained by intraoperative lavage. Cytokines were measured by immunoassay. To assess the net impact of the mediators within plasma, the authors studied the ability of patient plasma to augment or suppress bacterial lipopolysaccharide (LPS) stimulation of monocytes in vitro. Results: Of the proinflammatory cytokines, tumor necrosis factor-alpha was present in PF but not in plasma, interleukin (IL)-1β and interferon-γ were found in low concentrations in both PF and plasma, and IL-12 (p70) was detectable in plasma but not PF. In contrast, IL-6 and IL-1 receptor antagonist (IL-1ra) were the most abundant cytokines in the PF and plasma, and the concentrations of IL-4 and IL-10 were also elevated in both compartments. Patients with more severe appendicitis had higher plasma levels of IL-6 and IL-10 and lower plasma levels of IL-12 and interferon-γ than did those with uncomplicated disease. Patient plasma inhibited LPS-induced stimulation of a monocyte cell line, and this inhibition was accentuated by complicated disease. Conclusions: As judged from the pattern of soluble cytokines in plasma and the effect of the plasma on monocyte activation by LPS, mild, localized infection can induce a systemic response that is predominantly anti-inflammatory.

Original languageEnglish (US)
Pages (from-to)408-416
Number of pages9
JournalAnnals of Surgery
Volume237
Issue number3
DOIs
StatePublished - Mar 2003

Fingerprint

Appendix
Cytokines
Inflammation
Ascitic Fluid
Lipopolysaccharides
Monocytes
Systemic Inflammatory Response Syndrome
Appendicitis
Interleukin-12
Interleukin-10
Interferons
Interleukin-6
Infection
Interleukin-1 Receptors
Blood Cell Count
Therapeutic Irrigation
Respiratory Rate
Body Temperature
Interleukin-1
Immunoassay

ASJC Scopus subject areas

  • Surgery

Cite this

Rivera-Chavez, F. A., Wheeler, H., Lindberg, G., Munford, R. S., & O'Keefe, G. E. (2003). Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix. Annals of Surgery, 237(3), 408-416. https://doi.org/10.1097/00000658-200303000-00016

Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix. / Rivera-Chavez, Fernando A.; Wheeler, Herbert; Lindberg, Guy; Munford, Robert S.; O'Keefe, Grant E.

In: Annals of Surgery, Vol. 237, No. 3, 03.2003, p. 408-416.

Research output: Contribution to journalArticle

Rivera-Chavez, FA, Wheeler, H, Lindberg, G, Munford, RS & O'Keefe, GE 2003, 'Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix', Annals of Surgery, vol. 237, no. 3, pp. 408-416. https://doi.org/10.1097/00000658-200303000-00016
Rivera-Chavez, Fernando A. ; Wheeler, Herbert ; Lindberg, Guy ; Munford, Robert S. ; O'Keefe, Grant E. / Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix. In: Annals of Surgery. 2003 ; Vol. 237, No. 3. pp. 408-416.
@article{6dab52fabbdb4c7987aa34f7518a5a4f,
title = "Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix",
abstract = "Objective: To measure local (peritoneal fluid) and systemic (plasma) cytokine profiles in patients with infection-inflammation of the vermiform appendix, a relatively mild, localized inflammatory process. Summary Background Data: The systemic host response to invading microorganisms, often termed the systemic inflammatory response syndrome (SIRS), includes changes in heart rate, respiratory rate, body temperature, and circulating white blood cell numbers. Although these changes can be induced experimentally by administering proinflammatory cytokines, the mediators that appear in the bloodstream during early, localized infection in humans have not been defined. Methods: The authors studied 56 patients with pathologically proven appendicitis. Blood was obtained before the induction of anesthesia, when 82{\%} of the patients met the criteria for SIRS. Peritoneal fluid (PF) was obtained by intraoperative lavage. Cytokines were measured by immunoassay. To assess the net impact of the mediators within plasma, the authors studied the ability of patient plasma to augment or suppress bacterial lipopolysaccharide (LPS) stimulation of monocytes in vitro. Results: Of the proinflammatory cytokines, tumor necrosis factor-alpha was present in PF but not in plasma, interleukin (IL)-1β and interferon-γ were found in low concentrations in both PF and plasma, and IL-12 (p70) was detectable in plasma but not PF. In contrast, IL-6 and IL-1 receptor antagonist (IL-1ra) were the most abundant cytokines in the PF and plasma, and the concentrations of IL-4 and IL-10 were also elevated in both compartments. Patients with more severe appendicitis had higher plasma levels of IL-6 and IL-10 and lower plasma levels of IL-12 and interferon-γ than did those with uncomplicated disease. Patient plasma inhibited LPS-induced stimulation of a monocyte cell line, and this inhibition was accentuated by complicated disease. Conclusions: As judged from the pattern of soluble cytokines in plasma and the effect of the plasma on monocyte activation by LPS, mild, localized infection can induce a systemic response that is predominantly anti-inflammatory.",
author = "Rivera-Chavez, {Fernando A.} and Herbert Wheeler and Guy Lindberg and Munford, {Robert S.} and O'Keefe, {Grant E.}",
year = "2003",
month = "3",
doi = "10.1097/00000658-200303000-00016",
language = "English (US)",
volume = "237",
pages = "408--416",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Regional and Systemic Cytokine Responses to Acute Inflammation of the Vermiform Appendix

AU - Rivera-Chavez, Fernando A.

AU - Wheeler, Herbert

AU - Lindberg, Guy

AU - Munford, Robert S.

AU - O'Keefe, Grant E.

PY - 2003/3

Y1 - 2003/3

N2 - Objective: To measure local (peritoneal fluid) and systemic (plasma) cytokine profiles in patients with infection-inflammation of the vermiform appendix, a relatively mild, localized inflammatory process. Summary Background Data: The systemic host response to invading microorganisms, often termed the systemic inflammatory response syndrome (SIRS), includes changes in heart rate, respiratory rate, body temperature, and circulating white blood cell numbers. Although these changes can be induced experimentally by administering proinflammatory cytokines, the mediators that appear in the bloodstream during early, localized infection in humans have not been defined. Methods: The authors studied 56 patients with pathologically proven appendicitis. Blood was obtained before the induction of anesthesia, when 82% of the patients met the criteria for SIRS. Peritoneal fluid (PF) was obtained by intraoperative lavage. Cytokines were measured by immunoassay. To assess the net impact of the mediators within plasma, the authors studied the ability of patient plasma to augment or suppress bacterial lipopolysaccharide (LPS) stimulation of monocytes in vitro. Results: Of the proinflammatory cytokines, tumor necrosis factor-alpha was present in PF but not in plasma, interleukin (IL)-1β and interferon-γ were found in low concentrations in both PF and plasma, and IL-12 (p70) was detectable in plasma but not PF. In contrast, IL-6 and IL-1 receptor antagonist (IL-1ra) were the most abundant cytokines in the PF and plasma, and the concentrations of IL-4 and IL-10 were also elevated in both compartments. Patients with more severe appendicitis had higher plasma levels of IL-6 and IL-10 and lower plasma levels of IL-12 and interferon-γ than did those with uncomplicated disease. Patient plasma inhibited LPS-induced stimulation of a monocyte cell line, and this inhibition was accentuated by complicated disease. Conclusions: As judged from the pattern of soluble cytokines in plasma and the effect of the plasma on monocyte activation by LPS, mild, localized infection can induce a systemic response that is predominantly anti-inflammatory.

AB - Objective: To measure local (peritoneal fluid) and systemic (plasma) cytokine profiles in patients with infection-inflammation of the vermiform appendix, a relatively mild, localized inflammatory process. Summary Background Data: The systemic host response to invading microorganisms, often termed the systemic inflammatory response syndrome (SIRS), includes changes in heart rate, respiratory rate, body temperature, and circulating white blood cell numbers. Although these changes can be induced experimentally by administering proinflammatory cytokines, the mediators that appear in the bloodstream during early, localized infection in humans have not been defined. Methods: The authors studied 56 patients with pathologically proven appendicitis. Blood was obtained before the induction of anesthesia, when 82% of the patients met the criteria for SIRS. Peritoneal fluid (PF) was obtained by intraoperative lavage. Cytokines were measured by immunoassay. To assess the net impact of the mediators within plasma, the authors studied the ability of patient plasma to augment or suppress bacterial lipopolysaccharide (LPS) stimulation of monocytes in vitro. Results: Of the proinflammatory cytokines, tumor necrosis factor-alpha was present in PF but not in plasma, interleukin (IL)-1β and interferon-γ were found in low concentrations in both PF and plasma, and IL-12 (p70) was detectable in plasma but not PF. In contrast, IL-6 and IL-1 receptor antagonist (IL-1ra) were the most abundant cytokines in the PF and plasma, and the concentrations of IL-4 and IL-10 were also elevated in both compartments. Patients with more severe appendicitis had higher plasma levels of IL-6 and IL-10 and lower plasma levels of IL-12 and interferon-γ than did those with uncomplicated disease. Patient plasma inhibited LPS-induced stimulation of a monocyte cell line, and this inhibition was accentuated by complicated disease. Conclusions: As judged from the pattern of soluble cytokines in plasma and the effect of the plasma on monocyte activation by LPS, mild, localized infection can induce a systemic response that is predominantly anti-inflammatory.

UR - http://www.scopus.com/inward/record.url?scp=0037362837&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037362837&partnerID=8YFLogxK

U2 - 10.1097/00000658-200303000-00016

DO - 10.1097/00000658-200303000-00016

M3 - Article

C2 - 12616126

VL - 237

SP - 408

EP - 416

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 3

ER -