Reduced serum cholinesterase activity indicates splenic modulation of the sterile inflammation

• Verfasst von: Živković, Aleksandar [VerfasserIn]
• Verfasst von: Tourelle, Kevin M. [VerfasserIn]
• Verfasst von: Brenner, Thorsten [VerfasserIn]
• Verfasst von: Weigand, Markus A. [VerfasserIn]
• Verfasst von: Hofer, Stefan [VerfasserIn]
• Verfasst von: Schmidt, Karsten [VerfasserIn]
• Titel: Reduced serum cholinesterase activity indicates splenic modulation of the sterile inflammation
• Verf.angabe: Aleksandar R. Zivkovic, MD, Kevin M. Tourelle, Thorsten Brenner, MD, Markus A. Weigand, MD, Stefan Hofer, MD, and Karsten Schmidt, MD
• E-Jahr: 2017
• Jahr: 17 August 2017
• Umfang: 9 S.
• Fussnoten: Gesehen am 21.08.2018
• Titel Quelle: Enthalten in: Journal of surgical research
• Ort Quelle: Orlando, Fla. : Academic Press, 1961
• Jahr Quelle: 2017
• Band/Heft Quelle: 220(2017), Seite 275-283
• ISSN Quelle: 1095-8673
• DOI: doi:10.1016/j.jss.2017.07.024
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Biomarker
• Sach-SW: Diagnosis
• Sach-SW: Infection
• Sach-SW: Pseudocholinesterase
• Sach-SW: Sepsis
• Sach-SW: SIRS
• K10plus-PPN: 1580245188

Abstract

Background - Sterile inflammation is an immediate and well-coordinated immune response to surgical injury. The cholinergic system plays a pivotal role in the inflammatory response. Induced inflammation stimulates the vagus nerve, which in turn activates anti-inflammatory nonneuronal processes. Serum cholinesterase (butyrylcholinesterase [BChE]) is an enzyme that hydrolyzes acetylcholine. Measuring the activity of the BChE in blood might indicate the level of the nonneuronal cholinergic activity. The spleen is a major organ of the immune system playing an important role during inflammation. A functional connection of the neuroimmune reflex has thus far been described only in experimental settings. - Materials and methods - In 48 patients receiving major pancreatic surgery, BChE activity was measured by applying point-of-care-testing, in addition to standard laboratory tests. - Results - The BChE activity decreased in patients receiving surgery. This reduction emerged much earlier than changes in C-reactive protein concentration, an inflammatory biomarker broadly used in the clinical environment. A milder reduction in the BChE activity was observed in patients subjected to surgery with splenectomy than in those with a preserved spleen. - Conclusions - The use of the point-of-care-testing system for quick bedside diagnostics and the rapid effects of inflammation on BChE levels provide a method and a marker to facilitate the early detection of systemic inflammation. Furthermore, this study provides evidence that the experimentally documented neuroimmune interaction is part of the physiological response to surgery-induced sterile inflammation. Splenic function plays an essential role in modulating the cholinergic anti-inflammatory response.