Background: Thoracic surgery mandates usually a one-lung ventilation (OLV) strategy with the collapse of the\r\noperated lung and ventilation of the non-operated lung. These procedures trigger a substantial inflammatory\r\nresponse. The aim of this study was to analyze the cytokine and chemokine reaction in both lungs, pleural space\r\nand blood in patients undergoing lung resection with OLV with special interest in the chemokine growthregulated\r\npeptide alpha (GROa) which is the human equivalent to the rat cytokine-induced neutrophil\r\nchemoattractant-1 (CINC-1).\r\nMethods: Broncho-alveolar lavage (BAL) fluid of both the collapsed, operated and the ventilated, non-operated\r\nlung, respectively, pleural space drainage fluid and blood was collected and the concentrations of interleukin (IL)-6,\r\nIL-1RA and GROa were determined with enzyme-linked immunosorbent assays in 15 patients.\r\nResults: Substantial inter-individual differences in the BAL fluid between patients in cytokine and chemokine levels\r\noccurred. In the pleural fluid and the blood these inter-individual differences were less pronounced. Both sides of the\r\nlung were affected and showed a significant increase in IL-6 and IL-1RA concentrations over time but not in GROa\r\nconcentrations. Except for IL-6, which increased more in the collapsed, operated lung, no difference between the\r\ncollapsed, operated and the ventilated, non-operated lung occurred. In the blood, IL-6 and IL-1RA increased early,\r\nalready at the end of surgery. GROa was not detectable. In the pleural fluid, both cytokine and chemokine\r\nconcentrations increased by day one. The increase was significantly higher in the pleural fluid compared to the blood.\r\nConclusion: The inflammatory response of cytokines affects both the collapsed, operated and the ventilated, nonoperated\r\nlungs. The difference in extent of response underlines the complexity of the inflammatory processes during\r\nOLV. In contrast to the cytokines, the chemokine GROa concentrations did not react in the BAL fluid or in the blood.\r\nThis indicates that GROa might not be useful as marker for the inflammatory reaction in complex surgical procedures.
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