Cytokines regulate the acute‑phase immune response to inflammation and tissue trauma. This prospective randomized study evaluated relationships among circulating cytokine measures — specifically interleukin‑18 (IL‑18), IL‑18 binding protein (IL‑18BP), and free interleukin‑18 (IL‑18F) — and clinical measures of postoperative pain and analgesic consumption in patients undergoing cholecystectomy by either minilaparotomy (MC) or laparoscopic (LC) approach. The principal objective was to assess whether blood levels of IL‑18F and related markers correlate with numerical rating scale (NRS) pain scores and the number of analgesic doses (NAD) after surgery.
The abstract reports that blood levels of IL‑18, IL‑18BP, IL‑18F and five other cytokine‑related markers were measured, and NRS pain surveys were performed preoperatively (PRE) and postoperatively (POP). The study is described as a prospective randomized trial including patients undergoing LC or MC. Specific methodological details — including total sample size, randomization procedure, timing of the POP2 sample, the exact analgesic protocols used, and full numeric data for all measured cytokines — were not reported in the abstract and require full‑text review.
Measured IL‑18F blood levels increased after surgery. The abstract reports an increase in IL‑18F between PRE and a postoperative sampling labeled POP2, with reported values of 632 versus 739 and a statistically significant rise (p < 0.01). The source does not specify whether these values are means or medians, nor the units or timing of POP2 in relation to surgery.
IL‑18F showed a very strong positive correlation with total IL‑18 (r = 0.92, p < 0.001). Additional reported correlations for IL‑18F include:
These relationships suggest that postoperative IL‑18F is concordant with total IL‑18 and with markers related to inflammasome or oxidative processes, although the clinical meaning of the smaller correlations (catalase, nitrotyrosine) is modest given the correlation coefficients.
The abstract reports statistically significant associations between cytokine levels and clinical pain measures in the cholecystectomy cohort:
Directionality of correlations reported in the abstract indicates inverse relationships for IL‑18F with NRS and NAD (small negative r values) while IL‑18BP had a small positive correlation with NRS but a small negative correlation with NAD. The magnitudes of these correlation coefficients are small, indicating limited explanatory power on an individual‑patient basis, although they reached statistical significance in this dataset.
According to the abstract, this is the first clinical report demonstrating that postoperative IL‑18F levels are significantly associated with NRS pain scores and the number of analgesic doses in patients who undergo cholecystectomy. The authors propose that IL‑18F and IL‑18BP may contribute to the acute‑phase immune response to surgical trauma and relate to postoperative pain and analgesic requirements.
These findings highlight a potential mechanistic link between perioperative cytokine dynamics and clinical pain outcomes, suggesting that measures of the IL‑18 axis could function as biomarkers of the immune response to surgical injury or as targets for future mechanistic or interventional studies.
The abstract provides correlations, p values, and two IL‑18F numeric values (632 vs 739) with significance testing, but it omits several details needed to interpret and apply the findings clinically:
Full‑text review is required to obtain these methodological and numerical specifics and to assess the robustness and generalizability of the reported associations.
Overall, the abstract documents statistically significant but modest correlations between postoperative IL‑18F/IL‑18BP and clinical pain measures after cholecystectomy, framing the IL‑18 axis as a plausible component of the acute‑phase response that warrants further detailed study.