TARGET EFFECTS OF ANGIOGENIC AND INFLAMMATORY STRESS IN PATIENTS DURING PERIOPERATIVE REGIONAL AND GENERAL ANESTHESIA FOR ELECTIVE CESAREAN SECTION


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Abstract

Objective. To estimate serum angiogenic and proinflammatory activities at the systemic level in patients during perioperative regional and general anesthesia for elective cesarean section. Subjects and methods. Sixty-two pregnant women aged 21 to 37years (30.9±6.2 years) who had delivered via caesarean section under general (n=33) and regional (n=20) anesthesia were followed up. The levels of vascular endothelial growth factor (VEGF)-A, soluble VEGF receptor 1 (sVEGFR-1), sVEGFR-2, angipoietin-1, angipoi-etin-2, plasma prealbumin, high-sensitivity C-reactive protein, serum amyloid, interleukin (IL)-1a, IL-6, and serum gene product 130 were determined by ELISA using the standard kits (R&D systems, USA). Results. Significant changes in the serum levels of pro- and anti-angiogenic growth factors, acute-phase inflammatory proteins, proinflammatory interleukins were established to be characteristic of an early postoperative period; the critical period of activated angiogenic and inflammatory stress for regional anesthesia involved moderate and weak responses 12 and 24 hours after postoperative wound suturing, respectively; that for general anesthesia was weak and moderate responses at 12 and 24 hours. No evident angiogenic and inflammatory responses were seen in any of the examined patients. Conclusion. To set off the critical periods of activated angiogenic and inflammatory stress according to the mode of anesthesia allows a differential approach to be applied to evaluating the patients’ condition to prevent complications in the early postoperative period.

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A. V BURLEV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health and Social Development of the Russian Federation

Email: a_bourlev@mail.ru

V. A BURLEV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health and Social Development of the Russian Federation

E. M SHIFMAN

Peoples' Friendship University of Russia

Department of Anesthesiology and Reanimatology, Faculty for Advanced Training of Medical Workers

N. A ILYASOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health and Social Development of the Russian Federation

G. T SUKHIKH

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health and Social Development of the Russian Federation

References

  1. Hall G.M., Desborough J.P. Interleukin-6 and the metabolic response to surgery. Br. J. Anaesth. 1992; 69: 337-8.
  2. Biffl W.L., Moore E.E., Moore F.A., Peterson V.M. Interleukin-6 in the injured patient. Marker of injury or mediator of inflammation? Ann. Surg. 1996; 224: 647-64.
  3. Malik E, Buchweitz O., Muller-Steinhardt M., Kressin P., Meyhofer-Malik A., Diedrich K. Prospective evaluation of the systemic immune response following abdominal, vaginal, and laparoscopically assisted vaginal hysterectomy. Surg. Endosc. 2001; 15: 463-6.
  4. Molloy R.G., Mannick J.A., Rodrick M.L. Cytokines, sepsis and immunomodulation. Br. J. Surg. 1993; 80: 289-97.
  5. Rixen D, Siegel J.H., Abu-Salih A., Bertolini M, Panagakos F, Espina N. Physiologic state severity classification as an indicator of posttrauma cytokine response. Shock. 1995; 4: 27-38.
  6. Takacs P., Green K.L., Nikaeo A., Kauma S.W. Increased vascular endothelial cell production of interleukin-6 in severe preeclampsia. Am. J. Obstet. Gynecol. 2003; 188: 740-4.
  7. Yokoyama M, Itano Y, Katayama H, Morimatsu H., Takeda Y., Takahashi T. et al. The effects of continuous epidural anesthesia and analgesia on stress response and immune function in patients undergoing radical esophagectomy. Anesth. Analg. 2005; 101(5): 1521-7.
  8. Moore C.M., Desborough J.P., Powell H, Burrin J.M., Hall G.M. Effects of extradural anaesthesia on interleukin-6 and acute phase response to surgery. Br. J. Anaesth. 1994; 72: 272-9.
  9. Hogevold H.E., Lyberg T., Kahler H., Haug E, Reikeras O. Changes in plasma IL-1b, TNF-a and IL-6 after total hip replacement surgery in general or regional anaesthesia. Cytokine. 2000; 12: 1156-9.
  10. Buyukkocak U, Caglayan O, Daphan C., Aydinuraz K., Saygun O., Agalar F. Similar effects of general and spinal anaesthesia on perioperative stress response in patients undergoing haemorrhoidectomy. Mediators Inflamm. 2006; 2006(1): 97257.
  11. Naito Y., Tamai S., Shingu K., Shindo K., Matsui T., Segawa H. et al. Responses of plasma adrenocorticotropic hormone, cortisol, and cytokines during and after upper abdominal surgery. Anesthesiology. 1992; 77(3): 426-31.
  12. De Jongh R.F., Bosmans E.P., Puylaert M.J., Ombelet W.U., Vandeput H.J., Berghmans R. A. The influence of anaesthetic techniques and type of delivery on peripartum serum interleukin-6 concentrations. Acta Anaesthesiol. Scand. 1997; 41: 853-60.
  13. Heegaard P.M., Stockmarr A., Pineiro M. Optimal combinations of acute phase proteins for detecting infectious disease in pigs. Vet. Res. 2011; 42(1): 50.
  14. Pallares F.J., Martinez-Subiela S., Seva J., Ramis G., Fuentes P., Bernabe A. et al. Relationship between serum acute phase protein concentrations and lesions in finishing pigs. Vet. J. 2008; 177(3): 369-73.
  15. Бурлев В.А. Воспалительный стресс: системный ангиогенез, белки острой фазы и продукты деструкции тканей у больных хроническим рецидивирующим сальпингоофо-ритом. Проблемы репродукции. 2011; 5: 25-32.
  16. Сокологороский С.В., Шифман Е.М., Бурлев А.В. и др. Комбинированная спинально-эпидуральная анестезия операции кесарева сечения: суммирование пороков или их коррекция? Регионарная анестезия и лечение острой боли. 2010; 3: 34-7.
  17. Chegini S., Johnston K.D., Kalantzis A., Dhariwal D.K. The effect of anesthetic technique on recovery after orthognathic surgery: a retrospective audit. Anesth. Prog. 2012;59(2):69-74.
  18. Looney M., Doran P., Buggy D.J. Effect of anesthetic technique on serum vascular endothelial growth factor C and transforming growth factor в in women undergoing anesthesia and surgery for breast cancer. Anesthesiology. 2010; 113(5): 1118-25.
  19. Buggy D.J., Smith G. Epidural anaesthesia and analgesia: Better outcome after major surgery? Growing evidence suggests so. Br. Med. J. 1999; 319: 530-1.
  20. Gottschalk A., Sharma S., Ford J., Durieux M.E., Tiouririne M. Review article: The role of the perioperative period in recurrence after cancer surgery. Anesth. Analg. 2010; 110(6): 1636-43.
  21. Deegan C.A., Murray D., Doran P., Ecimovic P., Moriarty D.C., Buggy D.J. Effect of anaesthetic technique on oestrogen receptor-negative breast cancer cell function in vitro. Br. J. Anaesth. 2009; 103: 685-90.
  22. Бурлев В.А. Аутопаракринные нарушения регуляции ангиогенеза при пролиферативных формах заболеваний женской репродуктивной системы. Акушерство и гинекология. 2006; 3: 34-40.
  23. Ferrara N., Houck K., Jakeman L., Leung D. W. Molecular and biological properties of the vascular endothelial growth factor family of proteins. Endocr. Rev. 1992; 13: 18-32.
  24. Maisonpierre P.C., Suri C., Jones P.F., Bartunkova S., Wiegand S.J., Radziejewski C. et al. Angiopoietin-2, a natural antagonist for Tie2 that disrupts in vivo angiogenesis. Science. 1997; 277(5322): 55-60.
  25. Kaysen G.A., Dubin J.A., Muller H.G. Relationships among inflammation nutrition and physiologic mechanisms establishing albumin levels in hemodialysis patients. Kidney Int. 2002; 61(6): 2240-9.
  26. Simic-Ogrizovic S., Dopsaj V., Bogavac-Stanojevic N. Serum amyloid-A rather than C-reactive protein is a better predictor of mortality in hemodialysis patients. Tohoku J. Exp. Med. 2009; 219(2): 121-7.
  27. Christoffersen M., Baagoe C.D., Jacobsen S., Bojesen A.M., Petersen M.R., Lehn-Jensen H. Evaluation of the systemic acute phase response and endometrial gene expression of serum amyloid A and pro- and anti-inflammatory cytokines in mares with experimentally induced endometritis. Vet. Immunol. Immunopathol. 2010; 138(1-2): 95-105.
  28. Kushner I., Jiang S.L., Zhang D., Lozanski G., Samols D. Do post-transcriptional mechanisms participate in induction of C-reactive protein and serum amyloid A by IL-6 and IL-1? Ann. N.Y. Acad. Sci. 1995; 762: 102-7.
  29. Muenzenmaier M., Depperschmid M., Gille G., Poets C.F., Orlikowsky T.W. C-reactive protein, detected with a highly sensitive assay, in non-infected newborns and those with early onset infection. Transfus. Med. Hemother. 2008; 35: 37-41.
  30. Gabay C., Lamacchia C., Palmer G. IL-1 pathways in inflammation and human diseases. Nat. Rev. Rheumatol. 2010; 6(4): 232-41.
  31. Pecoits-Filho R., Carvalho M.J., Stenvinkel P., Lindholm B., Heimbtirger O. Systemic and intraperitoneal interleukin-6 system during the first year of peritoneal dialysis. Perit. Dial. Int. 2006; 26(1): 53-63.
  32. Agic A., Xu H., Finas D., Banz C. Is endometriosis associated with systemic subclinical inflammation? Gynecol. Obstet. Invest. 2006; 62(3): 139-47.
  33. Petersen A.M., Pedersen B.K. The anti-inflammatory effect of exercise. J. Appl. Physiol. 2005; 98(4): 1154-62.
  34. Cruickshank A.M., Fraser W.D., Burns H.J., Van Damme J., Shenkin A. Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin. Sci. (Lond.). 1990; 79: 161-5.
  35. Zhong W.W., Burke P. A., Hand A.T., Walsh M. J., Hughes L.A., Forse R.A. Regulation of cytokine mRNA expression in lipopolysaccharide-stimulated human macrophages. Arch. Surg. 1993; 128: 158-64.
  36. Dermitzaki E., Staikou C., Petropoulos G., Rizos D., Siafaka I., Fassoulaki A. A randomized study of maternal serum cytokine levels following cesarean section under general or neuraxial anesthesia. Int. J. Obstet. Anesth. 2009; 18: 33-7.
  37. Silver J.S., Hunter C.A. gp130 at the nexus of inflammation, autoimmunity, and cancer. J. Leukoc. Biol. 2010; 88(6): 1145-56.

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