DETECTION OF NEOPTERIN, INTERLEUKIN-6 AND ACUTE-PHASE PROTEINS AS PARAMETERS OF POTENTIAL MONOCYTE ACTIVATION IN PREOPERATIVE PATIENTS

Monocytes play a key role in the immune response to trauma and infection. Is monocyte function already altered before surgery in terms of cell activation? On admission, serum neopterin was at or above 9 nmol/l in 50.2% and serum IL-6 was detectable (> 4 pg/ml) in 10.5% of 227 patients electively undergoing major abdominal surgery. Mean values of CRP (0.8 vs. 3.6), alpha-1-antitrypsin (267 vs. 376), albumin (4.0 vs. 3.5), prealbumin (27.0 vs, 17.9, all at p < 0.01) were significantly different in patients with or without monocyte activation (neopterin > 9 nmol/l and IL-6 > 4 pg/ml). There was a significant correlation between neopterin and the acute phase proteins (all at p < 0.01). The data reflect a ''primed'' state at least of some parts of the immune system in a subgroup of preoperative patients potentially affecting their response to surgical trauma and bacterial contamination.