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Postoperative serum attenuates LPS-induced release of TNF-alpha in orthopaedic surgery.
J Orthop Res. 2007 Oct; 25(10):1395-400.JO

Abstract

Studies with ex vivo stimulation of whole blood samples from injured patients have revealed a diminished production capacity for a broad range of secretory products, including inflammatory cytokines. Recent interest has focused on the release of mediators in serum that depress the cell-mediated immune response following trauma. The involvement of the lipid mediator prostaglandin E2 (PGE2) has been assumed because it is a potent endogenous immunosuppressor. In the present study, we tested the hypothesis that inhibitory substances circulating in the patient's serum after a major musculoskeletal trauma might impair leukocyte function by evaluating the effect of such serum on cytokine release in a whole blood model. Six females and three males undergoing elective total hip replacement were included in the study. Ex vivo LPS-induced TNF-alpha and IL-10 were measured in whole blood sampled preoperatively and added serum taken before, at the end of operation, and at postoperative days 1 and 6 with saline as negative control. LPS induced significant releases of TNF-alpha and IL-10 in whole blood. Addition of preoperative, postoperative, and day-1 postoperative serum did not alter the LPS-induced release of TNF-alpha as compared to saline. In the presence of serum from postoperative day 6, however, the expression of TNF-alpha was significantly reduced as compared to saline and preoperative serum (p = 0.021 and 0.008, respectively). Neither of the serum samples altered the release of IL-10. PGE2 was significantly (p = 0.008) increased in serum at postoperative day 6 as compared to preoperative levels. In conclusion, these data show that at day 6 after major orthopaedic surgery, the patient serum contained activity that inhibited ex vivo LPS-induced TNF-alpha release. The potent TNF-alpha inhibitory activity found at day 6 after injury correlated with increased levels of PGE2 and indicates cell-mediated hyporesponsiveness to a second stimulus.

Authors+Show Affiliations

Department of Orthopaedics, Rikshospitalet-Radiumhospitalet Medical Centre, University of Oslo, N-0027 Oslo, Norway. olav.reikeras@rikshospitalet.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17557348

Citation

Reikerås, Olav, et al. "Postoperative Serum Attenuates LPS-induced Release of TNF-alpha in Orthopaedic Surgery." Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society, vol. 25, no. 10, 2007, pp. 1395-400.
Reikerås O, Sun J, Wang JE, et al. Postoperative serum attenuates LPS-induced release of TNF-alpha in orthopaedic surgery. J Orthop Res. 2007;25(10):1395-400.
Reikerås, O., Sun, J., Wang, J. E., & Aasen, A. O. (2007). Postoperative serum attenuates LPS-induced release of TNF-alpha in orthopaedic surgery. Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society, 25(10), 1395-400.
Reikerås O, et al. Postoperative Serum Attenuates LPS-induced Release of TNF-alpha in Orthopaedic Surgery. J Orthop Res. 2007;25(10):1395-400. PubMed PMID: 17557348.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative serum attenuates LPS-induced release of TNF-alpha in orthopaedic surgery. AU - Reikerås,Olav, AU - Sun,Jingbo, AU - Wang,Jacob E, AU - Aasen,Ansgar O, PY - 2007/6/9/pubmed PY - 2007/10/17/medline PY - 2007/6/9/entrez SP - 1395 EP - 400 JF - Journal of orthopaedic research : official publication of the Orthopaedic Research Society JO - J Orthop Res VL - 25 IS - 10 N2 - Studies with ex vivo stimulation of whole blood samples from injured patients have revealed a diminished production capacity for a broad range of secretory products, including inflammatory cytokines. Recent interest has focused on the release of mediators in serum that depress the cell-mediated immune response following trauma. The involvement of the lipid mediator prostaglandin E2 (PGE2) has been assumed because it is a potent endogenous immunosuppressor. In the present study, we tested the hypothesis that inhibitory substances circulating in the patient's serum after a major musculoskeletal trauma might impair leukocyte function by evaluating the effect of such serum on cytokine release in a whole blood model. Six females and three males undergoing elective total hip replacement were included in the study. Ex vivo LPS-induced TNF-alpha and IL-10 were measured in whole blood sampled preoperatively and added serum taken before, at the end of operation, and at postoperative days 1 and 6 with saline as negative control. LPS induced significant releases of TNF-alpha and IL-10 in whole blood. Addition of preoperative, postoperative, and day-1 postoperative serum did not alter the LPS-induced release of TNF-alpha as compared to saline. In the presence of serum from postoperative day 6, however, the expression of TNF-alpha was significantly reduced as compared to saline and preoperative serum (p = 0.021 and 0.008, respectively). Neither of the serum samples altered the release of IL-10. PGE2 was significantly (p = 0.008) increased in serum at postoperative day 6 as compared to preoperative levels. In conclusion, these data show that at day 6 after major orthopaedic surgery, the patient serum contained activity that inhibited ex vivo LPS-induced TNF-alpha release. The potent TNF-alpha inhibitory activity found at day 6 after injury correlated with increased levels of PGE2 and indicates cell-mediated hyporesponsiveness to a second stimulus. SN - 0736-0266 UR - https://www.unboundmedicine.com/medline/citation/17557348/Postoperative_serum_attenuates_LPS_induced_release_of_TNF_alpha_in_orthopaedic_surgery_ L2 - https://doi.org/10.1002/jor.20454 DB - PRIME DP - Unbound Medicine ER -