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

Artikel i vetenskaplig tidskrift
Författare Sara Bromander
Rolf Anckarsäter
Marianne Kristiansson
Kaj Blennow
Henrik Zetterberg
Henrik Anckarsäter
Caroline Wass
Publicerad i Journal of neuroinflammation
Volym 9
Sidor 242
ISSN 1742-2094
Publiceringsår 2012
Publicerad vid Institutionen för neurovetenskap och fysiologi
Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
Centrum för etik, juridik och mental hälsa
Sidor 242
Språk en
Länkar dx.doi.org/10.1186/1742-2094-9-242
https://gup.ub.gu.se/file/96575
Ämnesord Cytokine, Blood–brain barrier, Central nervous system, Arthroplastic surgery, Cortisol, Albumin, Interleukin, Inflammation
Ämneskategorier Medicinska grundvetenskaper

Sammanfattning

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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