Tumor necrosis factor-alpha and interleukin-6 in peritoneal adhesion formation

Abstract

This study was carried out to assess the role of tumor necrosis factor (TNF-$alpha$) and interleukin-6 (IL-6 ) in plasma and peritoneal fluid in higher rates of adhesion formation following standard bowel injury. Forty-five albino rabbits were divided into three equal groups. Blood was obtained from all the rabbits preoperatively. All the rabbits were subjected to a laparotomy. In group 1(control group), the peritoneal cavity was irrigated with normal saline. In group 2 the cecal serosa was abraded, while the rabbits in group 3 had a resection in small bowel of 2 cm. A peritoneal catheter was placed in all the rabbits prior to closure. Blood samples were obtained at the 30th, 90th, and 150th min following the injury. Peritoneal exudate (PE) was collected and the catheter removed at the end of the 150th min: Blood samples and peritoneal exudate were processed and levels of TNF-$alpha$ and IL-6 were determined.The severity of adhesions was graded at the 3rd postroperative week using a score of 0-1 to 4. The plasma levels of TNF-$alpha$ and IL-6 correlated significantly with grades of adhesion. TNF-$alpha$ and IL-6 values also correlated significantly in peritoneal fluid. Rabbits in group 1 had significantly lower adhesion grades when compared with groups 2 and 3 which had higher postoperative plasma and PE TNF-$alpha$ and IL-6 levels than group 1. These correlations suggest that monitoring of the plasma and peritoneal exudate TNF-$alpha$ and IL-6 levels might be helpful biological markers for postoperative intra-abdominal adhesion formation.