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Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures

Year 2013, Volume: 18 Issue: 4, 176 - 180, 14.03.2014

Abstract

Abstract. Cytokines and acute phase proteins have been implicated in the systemic response to trauma. The aim of this study was to measure the IL-6, CRP, ALP, calcium and phosphorus levels in patients with trauma involving low-extremity bone fractures at 6, 24 and 48 hours following trauma. Serum samples were obtained from 21 trauma patients with femoral or tibial fractures at 6th, 24th and 48th hour following trauma. Serum IL-6, CRP, ALP, calcium and phosphorus levels were measured in these samples. Serum levels of IL-6, CRP and ALP at 24th hour were found to be significantly elevated in comparison to their levels at 6th hour (p=0.01, p<0.01 and p<0.05, respectively). Moreover, the levels of CRP and ALP were found to be significantly elevated at 48th hour compared to their levels at 6th hour (p<0.01). However, serum IL-6 levels at 48th hour were found to be lower than the levels at 6th hour (p<0.01). There was not a significant correlation between CRP and IL-6 levels at different time points. Serum calcium and phosphorus levels did not change significantly. We have demonstrated that IL-6 reached its peak level in 24 hours after trauma and its level in the 48th hour decreased below that of 6th hour. CRP, as an acute phase reactant, increased for the first 24 hours and stayed elevated for the next 24 hours. Further studies should be conducted to demonstrate the correlation between the extent of injury and IL-6 and CRP levels. Key words: Trauma, IL-6 and CRP

References

  • Balogh ZJ, Reumann MK, Gruen RLet al. Advances and future directions for management of trauma patients with musculoskeletal injuries. Lancet 2012; 380: 1109-1119.
  • Marik PE, Flemmer M. The immune response to surgery and trauma: Implications for treatment. J Trauma Acute Care Surg 2012; 73: 801-808.
  • Löwik CW, van der Pluijm G, Bloys H, et al. Parathyroid hormone (PTH) and PTH-like protein (PLP) stimulate interleukin-6 production by osteogenic cells: a possible role of interleukin-6 in osteoclastogenesis. Biochem Biophys Res Commun 1989; 162: 1546-1552.
  • Kitahara M, Kishimoto S, Hirano T, Kishimoto T, Okada M. The in vivo anti-tumor effect of human recombinant interleukin-6. Jpn J Cancer Res 1990; 81: 1032-1038.
  • Black K, Garrett IR, Mundy GR. Chinese hamster ovarian cells transfected with the murine interleukin-6 gene cause hypercalcemia as well as cachexia, leukocytosis and thrombocytosis in tumorbearing nude mice. Endocrinology 1991; 128: 265726
  • Girasole G, Jilka RL, Passeri G, et al. 17 betaestradiol inhibits interleukin-6 production by bone marrow-derived stromal cells and osteoblasts in vitro: a potential mechanism for the antiosteoporotic effect of estrogens. J Clin Invest 1992; 89: 883-891.
  • Jilka RL, Hangoc G, Girasole G, et al. Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science 1992; 257: 88
  • Gauldie J, Northemann W, Fey GH. IL-6 functions as an exocrine hormone in inflammation. Hepatocytes undergoing acute phase responses require exogenous IL-6. J Immunol 1990; 144: 3804-3808.
  • Yamasaki K, Taga T, Hirata Y, et al. Cloning and expression of the human interleukin-6 (BSF-2/IFN beta 2) receptor. Science 1988; 241: 825-828.
  • Sun CH, Li Y, Zhang YB, et al. The effect of vitamin-mineral supplementation on CRP and IL-6: a systemic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis 2011; 21: 576-583.
  • Orimo H. The mechanism of mineralization and the role of alkaline phosphatase in health and disease. J Nippon Med Sch 2010; 77: 4-12.
  • Wennberg C, Hessle L, Lundberg P, et al. Functional characterization of osteoblasts and osteoclasts from alkaline phosphatase knockout mice. J Bone Miner Res 2000; 15: 1879-1888.
  • Kushner I. The phenomenon of the acute phase response. Ann N Y Acad Sci 1982; 389: 39-48.
  • Yoon SI, Lim SS, Rha JD, et al. The C-reactive protein (CRP) in patients with long bone fractures and after arthroplasty. Int Orthop 1993; 17: 198-201.
  • Whicher JT, Dieppe PA. Acute phase proteins. Clin Immunol Allergy 1985; 5: 624-631.
  • Strecker W, Gebhard F, Rager J, et al. Early biochemical characterization of soft-tissue trauma and fracture trauma. J Trauma 1999; 47: 358-364.
  • Kalabalikis P, Papazoglou K, Gouriotis D, et al. Correlation between serum IL-6 and CRP levels and severity of head injury in children. Intensive Care Med 1999; 25: 288-292.
  • Pullicino EA, Carli F, Poole S, et al. The relationship between the circulating concentrations of interleukin 6 (IL-6), tumor necrosis factor (TNF) and the acute phase response to elective surgery and accidental injury. Lymphokine Res 1990; 9: 2312
  • Hoch RC, Rodriguez R, Manning T, Bishop M, Mead P, Shoemaker WC, Abraham E. Effects of accidental trauma on cytokine and endotoxin production. Crit Care Med 1993; 21: 839-845.
  • Kushner I, Feldmann G. Control of the acute phase response. Demonstration of C-reactive protein synthesis and secretion by hepatocytes during acute inflammation in the rabbit. J Exp Med 1978; 148: 466-4
  • Whicher JT, Evans SW. Acute phase proteins. Hosp Update Nov 1990; 899-990.
  • Shakespeare PG, Ball AJ, Spurr ED. Serum protein changes after abdominal surgery. Ann Clin Biochem 1989; 26: 49-57.
  • Giannoudis PV, Smith RM, Banks RE, et al. Stimulation of inflammatory markers after blunt trauma. Br J Surg 1998; 85: 986-990.
  • Seibel MJ, Pols HAP 1996 Clinical application of biochemical markers of bone metabolism. In: BilezikianJP, RaiszLG, RodanGA (eds.)Principle s of Bone Biology. Academic Press, San Diego, CA, U.S.A., pp. 1293–1311
  • Kress BC. Bone alkaline phosphatase: methods of quantitation and clinical utility. J Clin Ligand Assay 1998; 21: 139-148.
  • Morrone G, Ciliberto G, Oliviero S, et al. Recombinant interleukin 6 regulates the transcriptional activation of a set of human acute phase genes. J Biol Chem 1988; 263: 12554-12558.
  • Baumann H, Richards C, Gauldie J. Interaction among hepatocyte-stimulating factors, interleukin 1, and glucocorticoids for regulation of acute phase plasma proteins in human hepatoma(HepG2) cells. J Immunol 1987; 139: 4122-4128.
Year 2013, Volume: 18 Issue: 4, 176 - 180, 14.03.2014

Abstract

References

  • Balogh ZJ, Reumann MK, Gruen RLet al. Advances and future directions for management of trauma patients with musculoskeletal injuries. Lancet 2012; 380: 1109-1119.
  • Marik PE, Flemmer M. The immune response to surgery and trauma: Implications for treatment. J Trauma Acute Care Surg 2012; 73: 801-808.
  • Löwik CW, van der Pluijm G, Bloys H, et al. Parathyroid hormone (PTH) and PTH-like protein (PLP) stimulate interleukin-6 production by osteogenic cells: a possible role of interleukin-6 in osteoclastogenesis. Biochem Biophys Res Commun 1989; 162: 1546-1552.
  • Kitahara M, Kishimoto S, Hirano T, Kishimoto T, Okada M. The in vivo anti-tumor effect of human recombinant interleukin-6. Jpn J Cancer Res 1990; 81: 1032-1038.
  • Black K, Garrett IR, Mundy GR. Chinese hamster ovarian cells transfected with the murine interleukin-6 gene cause hypercalcemia as well as cachexia, leukocytosis and thrombocytosis in tumorbearing nude mice. Endocrinology 1991; 128: 265726
  • Girasole G, Jilka RL, Passeri G, et al. 17 betaestradiol inhibits interleukin-6 production by bone marrow-derived stromal cells and osteoblasts in vitro: a potential mechanism for the antiosteoporotic effect of estrogens. J Clin Invest 1992; 89: 883-891.
  • Jilka RL, Hangoc G, Girasole G, et al. Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science 1992; 257: 88
  • Gauldie J, Northemann W, Fey GH. IL-6 functions as an exocrine hormone in inflammation. Hepatocytes undergoing acute phase responses require exogenous IL-6. J Immunol 1990; 144: 3804-3808.
  • Yamasaki K, Taga T, Hirata Y, et al. Cloning and expression of the human interleukin-6 (BSF-2/IFN beta 2) receptor. Science 1988; 241: 825-828.
  • Sun CH, Li Y, Zhang YB, et al. The effect of vitamin-mineral supplementation on CRP and IL-6: a systemic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis 2011; 21: 576-583.
  • Orimo H. The mechanism of mineralization and the role of alkaline phosphatase in health and disease. J Nippon Med Sch 2010; 77: 4-12.
  • Wennberg C, Hessle L, Lundberg P, et al. Functional characterization of osteoblasts and osteoclasts from alkaline phosphatase knockout mice. J Bone Miner Res 2000; 15: 1879-1888.
  • Kushner I. The phenomenon of the acute phase response. Ann N Y Acad Sci 1982; 389: 39-48.
  • Yoon SI, Lim SS, Rha JD, et al. The C-reactive protein (CRP) in patients with long bone fractures and after arthroplasty. Int Orthop 1993; 17: 198-201.
  • Whicher JT, Dieppe PA. Acute phase proteins. Clin Immunol Allergy 1985; 5: 624-631.
  • Strecker W, Gebhard F, Rager J, et al. Early biochemical characterization of soft-tissue trauma and fracture trauma. J Trauma 1999; 47: 358-364.
  • Kalabalikis P, Papazoglou K, Gouriotis D, et al. Correlation between serum IL-6 and CRP levels and severity of head injury in children. Intensive Care Med 1999; 25: 288-292.
  • Pullicino EA, Carli F, Poole S, et al. The relationship between the circulating concentrations of interleukin 6 (IL-6), tumor necrosis factor (TNF) and the acute phase response to elective surgery and accidental injury. Lymphokine Res 1990; 9: 2312
  • Hoch RC, Rodriguez R, Manning T, Bishop M, Mead P, Shoemaker WC, Abraham E. Effects of accidental trauma on cytokine and endotoxin production. Crit Care Med 1993; 21: 839-845.
  • Kushner I, Feldmann G. Control of the acute phase response. Demonstration of C-reactive protein synthesis and secretion by hepatocytes during acute inflammation in the rabbit. J Exp Med 1978; 148: 466-4
  • Whicher JT, Evans SW. Acute phase proteins. Hosp Update Nov 1990; 899-990.
  • Shakespeare PG, Ball AJ, Spurr ED. Serum protein changes after abdominal surgery. Ann Clin Biochem 1989; 26: 49-57.
  • Giannoudis PV, Smith RM, Banks RE, et al. Stimulation of inflammatory markers after blunt trauma. Br J Surg 1998; 85: 986-990.
  • Seibel MJ, Pols HAP 1996 Clinical application of biochemical markers of bone metabolism. In: BilezikianJP, RaiszLG, RodanGA (eds.)Principle s of Bone Biology. Academic Press, San Diego, CA, U.S.A., pp. 1293–1311
  • Kress BC. Bone alkaline phosphatase: methods of quantitation and clinical utility. J Clin Ligand Assay 1998; 21: 139-148.
  • Morrone G, Ciliberto G, Oliviero S, et al. Recombinant interleukin 6 regulates the transcriptional activation of a set of human acute phase genes. J Biol Chem 1988; 263: 12554-12558.
  • Baumann H, Richards C, Gauldie J. Interaction among hepatocyte-stimulating factors, interleukin 1, and glucocorticoids for regulation of acute phase plasma proteins in human hepatoma(HepG2) cells. J Immunol 1987; 139: 4122-4128.
There are 27 citations in total.

Details

Primary Language English
Journal Section Articles
Authors

Cengiz Karakaya This is me

Noyana Tevfik This is me

Suat Ekin This is me

Babayev Elnur This is me

Publication Date March 14, 2014
Published in Issue Year 2013 Volume: 18 Issue: 4

Cite

APA Karakaya, C., Tevfik, N., Ekin, S., Elnur, B. (2014). Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures. EASTERN JOURNAL OF MEDICINE, 18(4), 176-180.
AMA Karakaya C, Tevfik N, Ekin S, Elnur B. Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures. EASTERN JOURNAL OF MEDICINE. March 2014;18(4):176-180.
Chicago Karakaya, Cengiz, Noyana Tevfik, Suat Ekin, and Babayev Elnur. “Serum IL-6 and CRP Levels in Patients With Trauma Involving Low-Extremity Bone Fractures”. EASTERN JOURNAL OF MEDICINE 18, no. 4 (March 2014): 176-80.
EndNote Karakaya C, Tevfik N, Ekin S, Elnur B (March 1, 2014) Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures. EASTERN JOURNAL OF MEDICINE 18 4 176–180.
IEEE C. Karakaya, N. Tevfik, S. Ekin, and B. Elnur, “Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures”, EASTERN JOURNAL OF MEDICINE, vol. 18, no. 4, pp. 176–180, 2014.
ISNAD Karakaya, Cengiz et al. “Serum IL-6 and CRP Levels in Patients With Trauma Involving Low-Extremity Bone Fractures”. EASTERN JOURNAL OF MEDICINE 18/4 (March 2014), 176-180.
JAMA Karakaya C, Tevfik N, Ekin S, Elnur B. Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures. EASTERN JOURNAL OF MEDICINE. 2014;18:176–180.
MLA Karakaya, Cengiz et al. “Serum IL-6 and CRP Levels in Patients With Trauma Involving Low-Extremity Bone Fractures”. EASTERN JOURNAL OF MEDICINE, vol. 18, no. 4, 2014, pp. 176-80.
Vancouver Karakaya C, Tevfik N, Ekin S, Elnur B. Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures. EASTERN JOURNAL OF MEDICINE. 2014;18(4):176-80.