Evaluation of interleukin 1-beta and tumor necrosis factor alpha in the preoperative patient

Introduction: It is well known that the body rapidly initiates an inflammatory response to trauma. The proinflammatory cascade is instrumental in driving this response. IL-1β and TNF-α are recognized proinflammatory cytokines. Review of the literature shows a paucity of studies looking at baseline cytokine levels in the preoperative patient. The purpose of this study is to determine the cytokine levels of IL-1β and TNF-α in a group of consecutive preoperative adult patients. Methods: All elective preoperative adult patients being seen in the Ambulatory Processing Clinic and scheduled to have their blood drawn were prospectively screened for inclusion in this study. Exclusion criteria were any use of NSAIDS or steroids in the last 5 days, preoperative chemotherapy, pregnancy, known HIV positive, or history of chronic narcotic use. All samples were obtained with the patients' other scheduled blood sampling, using lithium heparin coated test tubes. The samples were then centrifuged at 3000 Rpm's for 5 min and the plasma was extracted and frozen at 70 Celsius. Cytokine analysis was conducted with electrochemi-luminescence (Orgin analyzer, Rockville, MD). Results: Thirty patients were studied and 5 patients had markedly elevated IL-1β (>2000 pg/ml) and TNF-a (12683 +/915 pg/ml). 23 patients had levels equivalent to physiological zero (<10 pg/ml) for both cytokines. One patient had an isolated elevation in TNF-α, and one in IL-1β. Conclusion: Of a group of consecutive elective preoperative adults 23% can be expected to have elevated serum levels of IL-1β and TNF-α.