Perioperative Inflammatory Cytokines in Parkinson's Disease

Background: Neuroinflammation is increasingly recognized as an important contributor to Parkinson's disease (PD), yet perioperative immune responses in this population remain incompletely characterized. This study investigated perioperative cytokine dynamics in patients with PD compared with healthy controls (HCs) undergoing orthopedic surgery under general anesthesia. Methods: In this prospective pilot observational study, 50 patients scheduled for lower limb orthopedic surgery were enrolled (25 PD patients, 25 HCs). Serum cytokines (IL-6, IL-8, VEGF, MCP-1, HMGB1, S100B, and PARK7) were measured immediately after anesthesia induction (PRE) and 24 h postoperatively (POST). Between-group comparisons were performed using independent t-tests, and within-group perioperative changes were assessed using paired t-tests. Absolute (Δ = POST - PRE) and relative perioperative changes were analyzed. Results: IL-6 increased significantly after surgery in both groups, with no significant differences in absolute or relative perioperative changes between the PD and HC group. IL-8 concentrations were numerically higher in PD patients at both time points, but perioperative changes did not differ significantly between groups. VEGF decreased modestly within the PD group, whereas no significant change was observed in HCs; however, between-group differences in perioperative VEGF changes were not significant. S100B and PARK7 increased postoperatively in HCs but not in PD patients, while MCP-1 and HMGB1 showed no significant perioperative changes. Conclusions: In this pilot study, perioperative cytokine responses in patients with PD were largely comparable to those in HCs. Despite evidence of chronic low-grade inflammation in the PD group, no disease-specific amplification of acute perioperative inflammatory responses was observed. These findings suggest that perioperative immune activation in PD may be selective rather than global.