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Increase of interleukin-6 plasma levels after elective craniotomy: Influence of interleukin-10 and catecholamines

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Summary

Accidental and operative trauma are able to induce a systemic reaction of the organism characterized by fever, leukocytosis, catabolism, and an activation of the coagulation system. Interleukin-6 (IL-6) has been found to be an important mediator of this acute-phase response. In this study the influence of elective craniotomy on IL-6 plasma levels was evaluated. Blood samples were obtained from 20 patients undergoing elective craniotorny for vascular or tumorous diseases of the brain. IL-6 increased significantly (p < 0.05) from the pre-operative (0 (0–5.4) pg/ml) to the intraoperative (180 min after beginning of surgery) time-point (10.6 (0–18.5) pg/ml). The maximum was reached on the first postoperative morning (13.9 (4.3–45.0) pg/ml). Interleukin-10 (IL-10) is an anti-inflammatory cytokine which suppresses IL-6 synthesis in vitro in various cell lines. IL-10 plasma concentrations showed no alterations throughout the study period. Epinephrine plasma concentrations increased significantly from pre-operative values (15 (0–74) pg/ml) to the postoperative time-point (57 (9–459) pg/ml). A 4.5-fold increase (p < 0.05) of norepinephrine plasma concentrations was found when comparing the data obtained 60 min after beginning of surgery with the data of the first postoperative morning. In monocytes, which are a major source of plasma IL-6, an elevation of intracellular cAMP stimulates the IL-6 synthesis. The postoperative maximum of IL-6 in plasma could be due to a release of catecholamines. In conclusion this study demonstrated an elevation of IL-6 plasma concentrations during and after elective craniotomy. Increased plasma catecholamine concentrations as well as a damage in the blood-brain barrier due to the surgical trauma with a spill-over of IL-6 from brain tissue into plasma could have contributed to this result.

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Authors and Affiliations

  1. Department of Anaesthesiology and Intensive Care Medicine, University of Giessen, Federal Republic of Germany

    M. Heesen, G. V. Dietrich, O. Detsch, J. Boldt & G. Hempelmann

  2. Department of Neurosurgery, University of Giessen, Federal Republic of Germany

    W. Deinsberger

Authors
  1. M. Heesen
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  2. W. Deinsberger
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  3. G. V. Dietrich
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  4. O. Detsch
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  5. J. Boldt
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  6. G. Hempelmann
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Heesen, M., Deinsberger, W., Dietrich, G.V. et al. Increase of interleukin-6 plasma levels after elective craniotomy: Influence of interleukin-10 and catecholamines. Acta neurochir 138, 77–80 (1996). https://doi.org/10.1007/BF01411728

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