Who Is Afraid of CRP? Elevated Preoperative CRP Levels Might Attenuate the Increase in Inflammatory Parameters in Response to Lung Cancer Surgery

Journal of Clinical Medicine

Oliver Dörr¹  Holger Nef¹  Helge Hudel²  Ali Erdogan³  Alisa Agné⁴  Veronika Grau⁴  Leon Brandenburg⁴  Winfried Padberg⁴  Biruta Witte⁴  MoritzMecki Meyer⁴  Anca-Laura Amati⁴ 

[1] German Centre for Cardiovascular Research (DZHK), Department of Cardiology, University of Giessen, D-35385 Giessen, Germany;Institute of Medical Informatics Medical Statistics, Justus-Liebig-University Giessen, D-35385Giessen, Germany;Internist Practice Center, Balserische Stiftung Hospital, D-35392 Giessen, Germany;Laboratory of Experimental Surgery, German Center for Lung Research, Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, D-35385 Giessen, Germany;

关键词: atorvastatin;    C-reactive protein;    fever;    gender;    inflammatory complications;    interleukin-1β;   

DOI  :  10.3390/jcm9103340

来源: DOAJ

【 摘 要 】

During surgery, ATP from damaged cells induces the release of interleukin-1β, a potent pro-inflammatory cytokine that contributes to the development of postoperative systemic inflammation, sepsis and multi-organ damage. We recently demonstrated that C-reactive protein (CRP) inhibits the ATP-induced release of monocytic interleukin-1β, although high CRP levels are deemed to be a poor prognostic marker. Here, we retrospectively investigated if preoperative CRP levels correlate with postoperative CRP, leukocyte counts and fever in the context of anatomical lung resection and systematic lymph node dissection as first line lung cancer therapy. No correlation was found in the overall results. In men, however, preoperative CRP and leukocyte counts positively correlated on postoperative days one to two, and a negative correlation of CRP and fever was seen in women. These correlations were more pronounced in men taking statins and in statin-naïve women. Accordingly, the inhibitory effect of CRP on the ATP-induced interleukin-1β release was blunted in monocytes from coronary heart disease patients treated with atorvastatin compared to monocytes obtained before medication. Hence, the common notion that elevated CRP levels predict more severe postoperative inflammation should be questioned. We rather hypothesize that in women and statin-naïve patients, high CRP levels attenuate trauma-induced increases in inflammatory markers.

【 授权许可】

Unknown