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Changes in serum and cerebrospinal fluid cytokines in response to non-neurological surgery: an observational study.

Journal article
Authors Sara Bromander
Rolf Anckarsäter
Marianne Kristiansson
Kaj Blennow
Henrik Zetterberg
Henrik Anckarsäter
Caroline Wass
Published in Journal of neuroinflammation
Volume 9
Pages 242
ISSN 1742-2094
Publication year 2012
Published at Institute of Neuroscience and Physiology
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Centre for Ethics, Law, and Mental Health
Pages 242
Language en
Links dx.doi.org/10.1186/1742-2094-9-242
https://gup.ub.gu.se/file/96575
Keywords Cytokine, Blood–brain barrier, Central nervous system, Arthroplastic surgery, Cortisol, Albumin, Interleukin, Inflammation
Subject categories Basic Medicine

Abstract

ABSTRACT: Background: Surgery launches an inflammatory reaction in the body, as seen through increased peripheral levels of cytokines and cortisol. However, less is known about perioperative inflammatory changes in the central nervous system (CNS). Our aim was to compare inflammatory markers in serum and cerebrospinal fluid (CSF) before and after surgery and evaluate their association with measures of blood–brain barrier (BBB) integrity. Methods: Thirty-five patients undergoing knee arthroplastic surgery with spinal anesthesia had CSF and serum samples drawn before, after and on the morning following surgery. Cytokines and albumin in serum and CSF and cortisol in CSF were assessed at all three points. Results: Cytokines and cortisol were significantly increased in serum and CSF after surgery (Ps <0.01) and CSF increases were greater than in serum. Ten individuals had an increased cytokine response and significantly higher CSF/serum albumin ratios (Ps <0.01), five of whom had albumin ratios in the pathological range (>11.8). Serum and CSF levels of cytokines were unrelated, but there were strong correlations between CSF IL-2, IL-10 and IL-13, and albumin ratios (Ps <0.05) following surgery. Conclusion: Cytokine increases in the CNS were substantially greater than in serum, indicating that the CNS inflammatory system is activated during peripheral surgery and may be regulated separately from that in the peripheral body. CSF cytokine increase may indicate sensitivity to trauma and is linked to BBB macromolecular permeability.

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