Reduced serum cholinesterase activity indicates splenic modulation of the sterile inflammation.
J Surg Res
; 220: 275-283, 2017 12.
Article
en En
| MEDLINE
| ID: mdl-29180192
ABSTRACT
BACKGROUND:
Sterile inflammation is an immediate and well-coordinated immune response to surgical injury. The cholinergic system plays a pivotal role in the inflammatory response. Induced inflammation stimulates the vagus nerve, which in turn activates anti-inflammatory nonneuronal processes. Serum cholinesterase (butyrylcholinesterase [BChE]) is an enzyme that hydrolyzes acetylcholine. Measuring the activity of the BChE in blood might indicate the level of the nonneuronal cholinergic activity. The spleen is a major organ of the immune system playing an important role during inflammation. A functional connection of the neuroimmune reflex has thus far been described only in experimental settings. MATERIALS ANDMETHODS:
In 48 patients receiving major pancreatic surgery, BChE activity was measured by applying point-of-care-testing, in addition to standard laboratory tests.RESULTS:
The BChE activity decreased in patients receiving surgery. This reduction emerged much earlier than changes in C-reactive protein concentration, an inflammatory biomarker broadly used in the clinical environment. A milder reduction in the BChE activity was observed in patients subjected to surgery with splenectomy than in those with a preserved spleen.CONCLUSIONS:
The use of the point-of-care-testing system for quick bedside diagnostics and the rapid effects of inflammation on BChE levels provide a method and a marker to facilitate the early detection of systemic inflammation. Furthermore, this study provides evidence that the experimentally documented neuroimmune interaction is part of the physiological response to surgery-induced sterile inflammation. Splenic function plays an essential role in modulating the cholinergic anti-inflammatory response.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Bazo
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Butirilcolinesterasa
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Síndrome de Respuesta Inflamatoria Sistémica
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Pruebas en el Punto de Atención
Tipo de estudio:
Diagnostic_studies
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Screening_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2017
Tipo del documento:
Article