Immunity & Ageing

unofficial impact factor 3.00

Open Access Research

Systemic inflammatory response in erderly patients following hernioplastical operation

Gaetano Di Vita1, Carmela R Balistreri2, Francesco Arcoleo3, Salvatore Buscemi1, Enrico Cillari3, Marcello Donati4, Maria Garofalo3, Florinda Listì2, Maria P Grimaldi2, Rosalia Patti1 and Giuseppina Candore2*

Author Affiliations

1 Sezione di Chirurgia generale, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università di Palermo, Italy

2 Gruppo di Studio sull'Immunosenescenza, Dipartimento di Biopatologia e Metodologie Biomediche, Università di Palermo, Italy

3 Laboratorio di Patologia Clinica, Azienda Ospedaliera V. Cervello, Palermo, Italy

4 Dipartimento di Scienze Chirurgiche, Trapianto e Tecniche avanzate, Università di Catania, Catania, Italy

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Immunity & Ageing 2006, 3:3 doi:10.1186/1742-4933-3-3

Published: 29 March 2006

Abstract

The number of old and oldest old patients undergoing surgery of varying severity is increasing. Ageing is a process that changes the performances of most physiological systems and increases susceptibility to diseases and death; accordingly, host responses to surgical stress are altered with ageing and the occurrence of age-related increase in susceptibility to post-operative complications has been claimed. Twenty-four male patients undergoing Lichtenstein (LH) hernioplasty for unilateral inguinal hernia were included in this study and divided in two groups (Young and Old respectively), according to their age. As expression of the acute phase response, we measured changes in concentration of pro-inflammatory cytokines Tumor necrosis factor-α and Interleukin-1β, leukocytes, acute phase proteins C-reactive protein and α 1-antitrypsin. Elderly humans showed prolonged and strong inflammatory activity compared to younger subjects in response to surgical stress, indicating that the acute-phase response to surgical stress of elderly humans varies from that of the young, showing initial hyperactivity and a delayed termination of the response. Thus, the acute phase response to surgical stress is higher in old subjects, but the clinical significance of this remains unclear. It is not known whether a causal relationship exists between this stronger acute phase response and the increases in susceptibility to post-operative complications observed in aged patients.