CYTOKINE REGULATION OF RESPIRATORY BURST IN BLOOD NEUTROPHILS FOR PREDICTION OF ABDOMINAL SEPSIS IN PATIENTS WITH EXTENDED PURULENT PERITONITIS

The aim of this study was to evaluate correlations between cytokine concentrations and parameters of respiratory burst in blood neutrophils, in order to predict potential development of abdominal sepsis in the patients with extended purulent peritonitis (EPP). The study involved fifteen patients with EPP. Peripheral blood samples were taken on the first day post-admissiona. Abdominal sepsis was diagnosed in thirty-five patients (70%) within 5…10 days after surgical intervention. Clinical complications were absent in fifteen patients (30%). Sixty-seven healthy individuals were examined as a control group. Evaluation of the cytokine concentrations was performed by ELISA technique. The degree of respiratory burst in blood neutrophils was measured by means of chemiluminescence assay.

It is revealed that the EPP patients exhibited increased levels of serum proinflammatory cytokines and IFNγ, along with higher intensity of respiratory burst in blood neutrophils, due to activated synthesis of of both primary and secondary reactive oxygen species (ROS). The EPP patients who later developed abdominal sepsis showed reduced spontaneous synthesis of primary ROS and increased spontaneous synthesis of secondary ROS. Upon zymosan induction of neutrophils, both primary and secondary ROS levels proved to be similar in the EPP subgroups with or without subsequent sepsis. EPP patients with uncomplicated post-surgical period still exhibited a predominant regulation of respiratory burst of neutrophils by IFNγ activity. Meanwhile, the neutrophil respiratory burst was correlated with TNFα and IL-6 in those patients who further developed abdominal sepsis. A stimulatory effect of IFNγ and a presumably inhibitory action of TNFα and IL-6 upon respiratory burst of blood neutrophils in EPP patients are associated with a release of large cytokine amounts during acute immune inflammatory events, and migration of activated cells to the inflammatory focus. In particular, the changes in the cytokine levels regulating the respiratory burst of neutrophils may be an important factor which predicts development of abdominal sepsis in EPP.

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