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The nonspecific inflammatory response to injury
1Department of Medicine, University of Alberta, Edmonton. irvin.mayers@ualberta.ca
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|November 18, 1998
Summary
Surgery can cause organ injury through a complex inflammatory response involving neutrophils and cytokines. Understanding these pathways, including nitric oxide metabolites, may lead to better surgical outcomes.
Area of Science:
- Inflammation and immunology
- Surgical pathology
Background:
- The nonspecific inflammatory response plays a critical role in post-surgical organ injury.
- Complex interactions involving neutrophils, cytokines, and nitric oxide metabolites contribute to this injury.
Purpose of the Study:
- To review the mechanisms of surgical injury mediated by nonspecific inflammatory pathways.
- To summarize the roles of neutrophils, cytokines, and nitric oxide in causing organ damage post-surgery.
Main Methods:
- A comprehensive literature review of medical and anesthetic studies was conducted using Medline.
- Relevant articles were identified through bibliographical searches of selected literature.
Main Results:
- Pro-inflammatory cytokines (e.g., tumor necrosis factor) are released in response to surgical stimuli, activating neutrophils.
- Increased nitric oxide production, combined with neutrophil-derived superoxide radicals, forms toxic peroxynitrite, leading to diffuse organ injury.
- Current data do not support firm clinical recommendations regarding specific anesthetics.
Conclusions:
- A complex interplay of inflammatory mediators underlies surgical injury.
- While direct clinical applications are limited, manipulating these pathways shows promise for improving surgical outcomes.