The tryptophan kynurenine pathway, neopterin and IL-6 during vulvectomy and abdominal hysterectomy

Journal of Biomedical Science

Durk Fekkes¹  Dirk L Stronks²  Markus Klimek²  Robert J Stolker²  Jaap Willem Hol² 

[1] Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands;Department of Anesthesiology, Erasmus Medical Center, Rotterdam, 3000 CA, The Netherlands

关键词: Neopterin;    Indoleamine 2,3-dioxygenase;    Tryptophan;    Kynurenine;   

Others  :  1139203
DOI  :  10.1186/s12929-014-0102-2

 received in 2014-05-14, accepted in 2014-11-07,  发布年份 2014

【 摘 要 】

Background

Surgery has wide ranging immunomodulatory properties of which the mechanism is poorly understood. In order to investigate how different types of surgery influence inflammation, we designed a longitudinal observational study investigating two inflammatory profiles of two separate patient groups undergoing gynaecological operations of differing severity. In addition to measuring the well known inflammatory markers neopterin and IL-6, we also determined the kynurenine/tryptophan ratio.

This study was a prospective, single center, two-armed observational study involving 28 female patients. Plasma levels of tryptophan, kynurenine, neopterin and IL-6 were determined from samples taken at: 24hrs pre-operative, prior to induction, ten minutes before the operation was expected to end, and at 24 and 96 hours post operative in patients undergoing abdominal hysterectomy and vulvectomy.

Results

There were 15 and 13 patients included in the vulvectomy and abdominal hysterectomy groups, respectively. In this study we show that anesthesia and surgery significantly increases the enzyme activity of indoleamine 2, 3 dioxygenase (IDO) as measured by the kynurenine/tryptophan ratio (P=0.003), while maintaining stable neopterin levels. However, abdominal hysterectomy causes a considerable IL-6 increase (P<0.001).

Conclusion

Surgery and associated anesthesia cause a significant tryptophan level decrease while significantly increasing IDO activity. Both types of surgery produce nearly identical neopterin time curve relationships, with no significant change occurring in either group. However, even though neopterin is unaffected by the severity of surgery, IL-6 responded to surgical invasiveness by revealing a significant increase during abdominal hysterectomy.

【 授权许可】

   
2014 Hol et al.; licensee BioMed Central.

【 图 表 】

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