Production of TNF-alpha in LPS stimulated pleural effusion and whole blood cells under surgical stress

Fifteen patients who underwent esophageal cancer operation were selected for this study. Whole blood and pleural effusion cells were obtained from the patients. Blood and pleural effusion cells were stimulated with LPS, and after 24 hours incubation. TNF-alpha concentrations in supernate were measured by enzyme-linked immunosorbent assay (ELISA). In a 3 hours after starting operation TNF-alpha production in whole blood was significantly (p<0.05) decreased compared with preoperative TNF-alpha production level and these suppression persisted up to day 3. On the other hand, the LPS-induced release of TNF-alpha into pleural effusion cells was markedly increased during the study period. These results suggest that TNF-alpha responses must be considered in relation to acting at different stages in injury and tissue origin of the cells in the critically ill patients.