Surgery
Volume 147, Issue 3 , Pages 366-372 , March 2010

Systemic Th17-like cytokine pattern in gangrenous appendicitis but not in phlegmonous appendicitis

  • Marie Rubér, MSc

      Affiliations

    • Department of Surgery, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    • Unit for Autoimmunity and Immunoregulation, County Hospital Ryhov, Jönköping, Sweden
    • Corresponding Author InformationReprint requests: Marie Rubér, MSc, Unit for Autoimmunity and Immunoregulation (AIR), Division of Surgery, Department of Clinical and Experimental Medicine, Pathology Building Floor 10, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden.
    • ,
  • Manne Andersson, MD

      Affiliations

    • Department of Surgery, County Hospital Ryhov, Jönköping, Sweden
    • ,
  • B. Fredrik Petersson, MD, PhD

      Affiliations

    • Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
    • ,
  • Gunnar Olaison, MD

      Affiliations

    • Department of Surgical Gastroenterology, Hvidovre Hospital, Copenhagen University, Faculty of Health Sciences, Copenhagen, Denmark
    • ,
  • Roland E. Andersson, MD, PhD

      Affiliations

    • Department of Surgery, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    • Department of Surgery, County Hospital Ryhov, Jönköping, Sweden
    • ,
  • Christina Ekerfelt, PhD

      Affiliations

    • Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    • Unit for Autoimmunity and Immunoregulation, County Hospital Ryhov, Jönköping, Sweden

,Accepted 29 September 2009.

References 

  1. Andersson RE. The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis. World J Surg. 2007;31:86–92
  2. Mason RJ. Surgery for appendicitis: is it necessary?. Surg Infect. 2008;9:481–488
  3. Decadt B, Sussman L, Lewis MP, Secker A, Cohen L, Rogers C, et al. Randomized clinical trial of early laparoscopy in the management of acute non-specific abdominal pain. Brit J Surg. 1999;86:1383–1386
  4. Howie JG. Too few appendicectomies?. Lancet. 1964;1:1240–1242
  5. Andersson R, Hugander A, Thulin A, Nystrom PO, Olaison G. Indications for operation in suspected appendicitis and incidence of perforation. BMJ. 1994;308:107–110
  6. Morino M, Pellegrino L, Castagna E, Farinella E, Mao P. Acute nonspecific abdominal pain: a randomized, controlled trial comparing early laparoscopy versus clinical observation. Ann Surg. 2006;244:881–886
  7. Livingston EH, Woodward WA, Sarosi GA, Haley RW. Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management. Ann Surg. 2007;245:886–892
  8. Andersson RE. Resolving appendicitis is common: further evidence. Ann Surg. 2008;247:553
  9. Heller MB, Skolnick ML. Ultrasound documentation of spontaneously resolving appendicitis. Am J Emerg Med. 1993;11:51–53
  10. Migraine S, Atri M, Bret PM, Lough JO, Hinchey JE. Spontaneously resolving acute appendicitis: clinical and sonographic documentation. Radiology. 1997;205:55–58
  11. Cobben LP, de Van Otterloo AM, Puylaert JB. Spontaneously resolving appendicitis: frequency and natural history in 60 patients. Radiology. 2000;215:349–352
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  13. Ciani S, Chuaqui B. Histological features of resolving acute, non-complicated phlegmonous appendicitis. Pathol Res Pract. 2000;196:89–93
  14. Luckmann R. Incidence and case fatality rates for acute appendicitis in California. A population-based study of the effects of age. Am J Epidemiol. 1989;129:905–918
  15. Arnbjornsson E, Bengmark S. Obstruction of the appendix lumen in relation to pathogenesis of acute appendicitis. Acta Chir Scand. 1983;149:789–791
  16. Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med. 2001;344:808–814
  17. Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy is followed by increased risk of Crohn's disease. Gastroenterology. 2003;124:40–46
  18. Andersson RE, Lambe M. Incidence of appendicitis during pregnancy. Int J Epidemiol. 2001;30:1281–1285
  19. Rivera-Chavez FA, Peters-Hybki DL, Barber RC, Lindberg GM, Jialal I, Munford RS, et al. Innate immunity genes influence the severity of acute appendicitis. Ann Surg. 2004;240:269–277
  20. Ruber M, Berg A, Ekerfelt C, Olaison G, Andersson RE. Different cytokine profiles in patients with a history of gangrenous or phlegmonous appendicitis. Clin Exp Immunol. 2006;143:117–124
  21. Bettelli E, Oukka M, Kuchroo VK. T(H)-17 cells in the circle of immunity and autoimmunity. Nat Immunol. 2007;8:345–350
  22. Kolls JK, Linden A. Interleukin-17 family members and inflammation. Immunity. 2004;21:467–476
  23. Rivera-Chavez FA, Wheeler H, Lindberg G, Munford RS, O'Keefe GE. Regional and systemic cytokine responses to acute inflammation of the vermiform appendix. Ann Surg. 2003;237:408–416
  24. Yoon DY, Chu J, Chandler C, Hiyama S, Thompson JE, Hinnes OJ. Human cytokine levels in nonperforated versus perforated appendicitis: molecular serum markers for extent of disease. Am Surg. 2002;68:1033–1036
  25. Paajanen H, Mansikka A, Laato M, Ristamäki R, Pulkkis K, Kostiainen S. Novel serum inflammatory markers in acute appendicitis. Scand J Clin Lab Invest. 2002;62:579–584

 Supported by grants from the Health Research Council in Southeast Sweden (FORSS).

 The work was supported by grants from the Health Research Council in Southeast Sweden (FORSS).

PII: S0039-6060(09)00609-6

doi: 10.1016/j.surg.2009.09.039

Surgery
Volume 147, Issue 3 , Pages 366-372 , March 2010

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