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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 31-36    DOI: 10.31083/j.ceog.2020.01.4963
Original Research Previous articles | Next articles
Influence of cytokines on the postoperative period
D. Jovanovic1, *(), D. R. Milovanovic2, I. Jovanovic3, M. Folic2, V. Jakovljevic4, 5
1Department of Anesthesiology and Reanimatology, Clinical Centre "Kragujevac", Kragujevac, Serbia
2Department of Clinical Pharmacology, Clinical Centre "Kragujevac", Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
3Department of Immunology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
4Department of Physiology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
5University IM Sechenov, Department of Human Pathology, 1st MOSCOW State Medical, Moscow Russian Federation, Serbia
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Purpose of Investigation: The relationships between postoperative recovery and changes of circulating levels of pro- and anti-inflammatory cytokines. Materials and Methods: The study included prospectively a cohort of 51 females who underwent abdominal hysterectomy for benign diseases. Recovery was assessed with Quality of Recovery 40 (QoR-40) questionnaire and concentrations of four cytokines during the 72-hours period were measured using human sensitive enzyme-linked immunosorbent assay (ELISA) kits. Results: Total QoR-40 score significantly declined on the first and the second postoperative days and then returned to baseline (p < 0.001). Interleukin-17 serum levels had no significant trend (p = 0.072). Statistically significant patterns of concentration changes of interferon gamma (p = 0.010), interleukin-10 (p < 0.001), and transforming growth factor (p = 0.016) were found. There were no significant correlations between QoR-40 scores and concentrations of any cytokine, at prespecified study power for moderate relationships at least. Conclusion: Recovery after abdominal hysterectomy was rapid and complete and it was unrelated to serum concentration profiles of examined cytokines.

Key words:  Hysterectomy      Postoperative recovery      Functional rehabilitation      Cytokines      Interleukins     
Published:  15 February 2020     
*Corresponding Author(s):  D. Jovanovic     E-mail:

Cite this article: 

D. Jovanovic, D. R. Milovanovic, I. Jovanovic, M. Folic, V. Jakovljevic. Influence of cytokines on the postoperative period. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 31-36.

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Figure 1.  — Serum concentrations of IL-17 (pg/mL) in 14 patients receiving morphine plus ketoprofen analgesia at different time points; squares represent medians and vertical bars represent the 25th and 75th percentiles, respectively *p < 0.05.

Table 1  — QoR-40 total score and serum concentration of cytokines in the entire study population in different time points.
Variable Baseline Visit 1 Visit 2 Visit 3 Visit 4
QoR-40 total score 188.6 ± 9.6 n.a. 170.6 ± 11.1* 180.4 ± 11.2* 187.7 ± 6.0
(165-200) (146-189) (152-195) (174-200)
IL-17 (pg/mL) 25.0 ± 21.4 20.4 ± 12.1* 20.3 ± 14.1* 22.8 ± 21.9 22.4 ± 18.7
(7.0-159.0, 23.1) (4.4-71.0, 17.9) (7.1-66.8, 15.5) (3.7-151.0, 16.5) (3.8-129.3, 17.9)
IFN-γ(pg/mL) 740.6 ± 1846.9
(0-11394.8, 60.7)
646.3 ± 1826.6*
(0-10302.7, 71.8)
591.7 ± 1956.5
(0-12845.6, 49.6)
739.8 ± 1845.8
(0-11634.3, 127.6)
255.0 ± 671.8*
(0-3759.2, 38.4)
IL-10 (pg/mL) 77.2 ± 126.4 88.5 ± 108.7 47.0 ± 91.8* 58.7 ± 81.4 45.5 ± 57.5
(0-557.7, 27.7) (10.2-690.8, 56.9) (0-540.1, 19.4) (0-330.5, 28.1) (0-296.6, 12.1)
TGF-β (pg/mL) 34.4 ± 13.6
(14.3-67.8, 32.8)
32.7 ± 14.5
(14.5-80.6, 30.1)
30.5 ± 11.1
(14.2-63.7, 28.8)
29.7 ± 11.6*
(14.8-74.6, 27.8)
27.3 ± 12.8*
(14.0-70.0, 25.7)
Figure 2.  — Changes (absolute differences) of IL-17 concentrations from V0 to V1 (panel A) and from V0 to V2 study period (panelB) in different patient subgroups receiving morphine plus ketorolac (ketorolac), morphine (morphine), morphine plus ketoprofen (ketoprofen) and morphine plus paracetamol (paracetamol), excluding five subjects with numeric pain rating scale score of four at the final visit; the boxplots represent medians with interquartile ranges and whiskers.

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