Role of serum C-reactive protein and interleukin-6 as a predictor of intra-abdominal and surgical site infections after elective abdominal surgery

The early detection of surgical site infection (SSI) remains an unsolved problem. Inflammatory factors in fluids drained from surgical sites may be a promising tool for predicting SSI. Previous attempts to predict SSI via such factors have not taken baseline concentrations into account. However, this may have comprised predictive efficacy. In the current study, concentrations of C-reactive protein (CRP) and interleukin 6 (IL-6) in fluid samples drained from surgical sites in 20 patients with SSI and 60 matched controls were assessed, and concentrations from day 2 to day 4 were divided by the concentration at day 1 to achieve concentration standardization. There were no significant differences of CRP or IL-6 concentrations at day 1 or day 2 ( p > 0.05), but there were significant differences at day 3 and day 4 ( p < 0.05). The areas under the curve (AUCs) for SSI of standardized concentrations were higher than those of the corresponding absolute concentrations of CRP and IL-6 in fluid drained at days 3 and 4. Standardized concentrations of CRP at day 4 yielded the highest AUC (0.92; 95% confidence interval: 0.84–0.97), with a sensitivity of 90% and specificity of 80% at the best cutoff. Concentration standardization may improve the efficacy of predicting SSI via CRP and IL-6 in fluids drained from surgical sites. Although the sample size was small, the study demonstrated the feasibility of non-invasive, accurate, and early detection of postoperative SSI in a diverse real population. Further studies are needed to validate the results of the present study and investigate their broader applicability. Impact statement The ability to predict surgical site infections (SSIs) early would be advantageous. Previous studies have investigated the use of inflammatory factors in fluids drained from surgical sites to predict SSI, but the diagnostic efficacy of this method requires improvement. Baseline levels of inflammatory factors vary between individuals, but this variation tends to differ in patients with and without SSIs. Therefore, we standardized subsequently acquired concentrations of interleukin 6 and C-reactive protein in fluids drained from surgical sites by dividing them by the concentrations determined at day 1 to preclude the confounding effects of differences in baseline levels. The standardized concentrations had higher predictive efficacy than the absolute concentrations. Standardizing the data rendered SSI prediction more precise and practical in a diverse group of real patients. This translational study suggests that inflammatory factors in fluid drained from injury sites are promising tools for the prediction of SSI in the clinic.

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Serum Interleukin 6, C-Reactive Protein and Pancreatic Secretory Trypsin Inhibitor (Psti) as Acute Phase Reactants After Major Thoraco-Abdominal Surgery

Immunological Investigations ◽

10.3109/08820139009041842 ◽

1990 ◽

Vol 19 (3) ◽

pp. 271-278 ◽

Cited By ~ 48

Author(s):

A. Murata ◽

M. Ogawa ◽

T. Yasuda ◽

J. Nishijima ◽

Y. Oka ◽

...

Keyword(s):

Abdominal Surgery ◽

Acute Phase ◽

Trypsin Inhibitor ◽

Interleukin 6 ◽

C Reactive Protein ◽

Pancreatic Secretory Trypsin Inhibitor ◽

Acute Phase Reactants ◽

Reactive Protein

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Is Cardiovascular Risk Associated with Subclinical Hypothyroidism: Role of C Reactive Protein and Interleukin-6

Journal of Cardiovascular Disease Research ◽

10.5530/jcdr.2018.1.5 ◽

2018 ◽

Vol 9 (1) ◽

pp. 20-23

Author(s):

Gaurav Gupta ◽

Preeti Sharma ◽

Pradeep Kumar ◽

Rachna Sharma

Keyword(s):

Cardiovascular Risk ◽

Subclinical Hypothyroidism ◽

Interleukin 6 ◽

C Reactive Protein ◽

Reactive Protein

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The effect of interleukin-1 on C-reactive protein expression in Hep3B cells is exerted at the transcriptional level

Biochemical Journal ◽

10.1042/bj3100143 ◽

1995 ◽

Vol 310 (1) ◽

pp. 143-148 ◽

Cited By ~ 55

Author(s):

D Zhang ◽

S L Jiang ◽

D Rzewnicki ◽

D Samols ◽

I Kushner

Keyword(s):

Interleukin 6 ◽

Interleukin 1 ◽

Kinetic Studies ◽

Acute Phase Reactant ◽

Transcriptional Level ◽

Mrna Levels ◽

C Reactive Protein ◽

Reactive Protein ◽

Hep3b Cells

The combination of interleukin 6 (IL-6) and interleukin 1 (IL-1) synergistically induces the human acute-phase reactant, C-reactive protein (CRP) in Hep3B cells. While previous studies have indicated that IL-6 induces transcription of CRP, the mode of action of IL-1 has not been clearly defined. It has been suggested that the effect of IL-1 might be post-transcriptional, exerted through the 5′-untranslated region (5′-UTR). To evaluate the role of IL-1 in CRP gene expression, we studied the effects of interleukin-6 (IL-6) and interleukin-1 beta (IL-1 beta) on both the endogenous CRP gene and on transfected CRP-CAT constructs in Hep3B cells. In kinetic studies of the endogenous CRP gene, IL-1 beta alone had no effect on CRP mRNA levels, but when added to IL-6, synergistically enhanced both CRP mRNA levels and transcription, as determined by Northern-blot analyses and nuclear run-on studies. IL-6 alone and the combination of [IL-1 beta + IL-6] each induced increases in mRNA levels roughly comparable with observed increases in transcription. These findings indicate that the effect of IL-1 beta on CRP expression is exerted largely at the transcriptional level in this system. This conclusion was confirmed by studies in Hep3B cells transiently transfected with CRP-CAT constructs, each containing 157 bp of the CRP 5′-flanking region but differing in the length of the 5′-UTR from 104 bp to 3 bp. All constructs responded in the same way; IL-6, but not IL-1 beta, induced significant chloramphenicol acetyltransferase (CAT) expression which was synergistically enhanced 2- to 3-fold by IL-1 beta. These results indicate that IL-1 beta stimulates transcriptional events in the presence of IL-6 and that the upstream 157 bases of the CRP promoter contain elements capable of both IL-6 induction and the synergistic effect of IL-1 beta on transcription.

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The Role of C-reactive Protein and Interleukin 6 in the Cases of Preeclampsia Associated with Obesity

Revista de Chimie ◽

10.37358/rc.19.3.7011 ◽

2019 ◽

Vol 70 (3) ◽

pp. 805-808 ◽

Cited By ~ 1

Author(s):

Izabella Petre ◽

Marius Craina ◽

Nicolae Suciu ◽

Alina Sisu ◽

Radu Dumitru Moleriu ◽

...

Keyword(s):

Risk Factor ◽

Early Detection ◽

Pregnant Women ◽

Interleukin 6 ◽

Inflammatory Markers ◽

Inflammatory Condition ◽

European Level ◽

C Reactive Protein ◽

Reactive Protein

In the management of preeclampsia/eclampsia, it would be useful at least at European level, to have clear protocols for early detection and approach of cases with hypertension, as well as to create an algorithm to identify the predisposition to hypertensive pregnancy pathology. The aim has been to identify the favorable factors and the evolution of the pregnancy in the 100 patients admitted to the obstetrics clinic between January 2014 and December 2018, aged between 15-44 years, who have been diagnosed with preeclampsia. In recent years, the management of pregnant women with preeclampsia has improved a lot due to a better understanding of the pathogenesis and a refinement of adequate pregnancy monitoring. Obesity has been shown to be a risk factor in preeclampsia. Several studies have identified preeclampsia as an inflammatory condition. A large number of inflammatory markers, such as C-reactive protein (PCR) and Interleukin 6 (IL-6), have been shown to be elevated in pregnant women with preeclampsia.

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Role of C-reactive protein and interleukin-6 in predicting the prognosis of ICU-admitted patients with acute exacerbation of COPD

Egyptian Journal of Chest Diseases and Tuberculosis ◽

10.1016/j.ejcdt.2014.06.003 ◽

2014 ◽

Vol 63 (4) ◽

pp. 829-835 ◽

Cited By ~ 1

Author(s):

Tamer Abdullah Helmy ◽

Ayman Ibrahim Baess ◽

Doaa Ali Abdel Monsif ◽

Ahmad Abdelhamid Ahmad Elnasharty

Keyword(s):

Acute Exacerbation ◽

Interleukin 6 ◽

C Reactive Protein ◽

Acute Exacerbation Of Copd ◽

Reactive Protein ◽

Exacerbation Of Copd

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PP-286. The role of interleukin-6 and C-reactive protein in nonthyroidal illness in premature infants followed-up in neonatal intensive care unit

Early Human Development ◽

10.1016/j.earlhumdev.2010.09.342 ◽

2010 ◽

Vol 86 ◽

pp. S130-S131

Author(s):

Dilek Dilli ◽

Suna Oguz ◽

Ugur Dilmen

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Premature Infants ◽

Interleukin 6 ◽

Neonatal Intensive Care ◽

C Reactive Protein ◽

Nonthyroidal Illness ◽

Reactive Protein

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The role of inflammatory biomarkers in CHD-associated pulmonary hypertension in children

Cardiology in the Young ◽

10.1017/s1047951116000408 ◽

2016 ◽

Vol 27 (2) ◽

pp. 255-260 ◽

Cited By ~ 2

Author(s):

Gokcen Oz-Tuncer ◽

Rana Olgunturk ◽

Ayhan Pektas ◽

Erman Cilsal ◽

Serdar Kula ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Ejection Fraction ◽

Interleukin 6 ◽

Inflammatory Markers ◽

Healthy Children ◽

C Reactive Protein ◽

Reactive Protein ◽

Hypertension In Children ◽

Fractional Shortening

AbstractObjectiveThe present study aims to identify the role of inflammatory markers such as C-reactive protein, interleukin-6, and fractalkine in CHD-associated pulmonary hypertension in children.MethodsThis is a prospective review of 37 children with CHD-related pulmonary hypertension, 21 children with congenital heart defects, and 22 healthy children.ResultsSerum C-reactive protein and interleukin-6 levels were significantly higher in the children with CHD-related pulmonary hypertension (respectively, p=0.049 and 0.026). Serum C-reactive protein concentrations correlated negatively with ejection fraction (r=−0.609, p=0.001) and fractional shortening (r=−0.452, p=0.007) in the pulmonary hypertension group. Serum fractalkine concentrations correlated negatively with ejection fraction (r=−0.522, p=0.002) and fractional shortening (r=−0.395, p=0.021) in the children with pulmonary hypertension. Serum interleukin-6 concentrations also correlated negatively with Qs (r=−0.572, p=0.021), positively with Rs (r=0.774, p=0.001), and positively with pulmonary wedge pressure (r=0.796, p=0.006) in the pulmonary hypertension group. A cut-off value of 2.2 IU/L for C-reactive protein was able to predict pulmonary hypertension with 77.5% sensitivity and 77.5% specificity. When the cut-off point for interleukin-6 concentration was 57.5 pg/ml, pulmonary hypertension could be predicted with 80% sensitivity and 75% specificity.ConclusionInflammation is associated with the pathophysiology of pulmonary hypertension. The inflammatory markers C-reactive protein and interleukin-6 may have a role in the clinical evaluation of paediatric pulmonary hypertension related to CHDs.

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