Levels of proinflammatory and immunosuppressive cytokines in peripheral blood in phlegmonous peritonitis patients

Abstract

Among surgical diseases, peritonitis is a life-threatening pathological condition characterized by inflammation at both local and systemic levels [8]. Identifying proinflammatory mediators in peripheral blood and in peritoneal fluid and their quantitative characteristic is vital for the diagnosis. High levels of these mediators may be indicators of complications development or lethal outcome [1]. It has been demonstrated that bacterial peritonitis in mice lethal outcome was linked to increased levels of tumor necrosis factor α (TNF α), interleukin 6 (IL-6), and lower contents of IL-10 [2]. Objective. To study the levels of proinflammatory and suppressive cytokines in the peripheral blood and compare their properties in patients with acute phlegmonous appendicitis, which causes peritonitis. Materials and methods. The study measured levels of proinflammatory and suppressive cytokines in the peripheral blood and compare their properties in patients with acute phlegmonous appendicitis, which causes peritonitis. Blood samples from 90 patients with peritonitis and 98 healthy volunteers were analyzed. Blood cytokine content was determined using enzyme-linked immunosorbent assay (Vector-Best). Optical density was measured on an analyzer “Stat FAX 303 PLUS” (USA, pg/ml). The results of the study were statistically analyzed using parametrical and nonparametrical criteria using “Minitab 16” software. Colmogorov-Smirnov test was used to determine the differences between the group of patients and the control group. Key numerical data was gathered and compared using the U-criteria of Mann-Whitney, whereas the average of the two independent data sets were analyzed using the Student method. The average quantitative changes and root-mean-square values for parametrical methods and the median with 1 and 3 quartile for nonparametrical values are presented. All persons who took part in the study gave their written consent as required by the bioethics committee. Results and their discussion. The research demonstrated that acute inflammation during phlegmonous peritonitis is characterized by mediator synergy between proinflammatory and suppressive potentials of the immune response at the systemic level. Significant (р<0,001) increase in the levels of proinflammatory (IL-1β, IL-6, TNF-α) and suppressive (IL-10, TGF-β) cytokines in the peripheral blood was observed in patients with phlegmonous peritonitis.