Assessment of plasma B7-H3 levels in pediatric patients with different degrees of surgical stress
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Published Version
Date
2016-07-26
Authors
Li, Yan
Yuan, Qing
Huang, Jie
Li, Yi Ping
Pan, Jian
Feng, Xing
Zhang, Xue Guang
Wang, Jiang Huai
Wang, Jian
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Published Version
Abstract
Background: Surgical stress initiates a series of host hormone, metabolism and immune responses, which predominantly affect the homeostatic mechanism of patients with major surgery. B7-H3 is a co-stimulatory molecule and has been shown to participate in both adaptive and innate immune responses. In this study we evaluated the clinical significance of plasma B7-H3 levels in pediatric patients with different types of operation and degrees of surgical stress. Methods: A total of 48 children received pediatric general and cardiac surgery were recruited into this study. Based on the surgical stress scoring, children were divided into moderate stress (n?=?14) and severe stress (n?=?34) groups. Plasma B7-H3 levels were assessed at selected time points: before surgery, immediately after surgery, at day 1, day 3, and day 7 after surgery. Correlations between plasma B7-H3 levels and surgical stress scores were also examined. Results: Plasma B7-H3 levels were significantly decreased in all 48 pediatric patients after surgery compared to the B7-H3 level before surgery (p?<?0.01). Children with general surgery showed significant decreases in plasma B7-H3 immediately after surgery, and at day 3 and day 7 after surgery (p?<?0.05, p?<?0.01), whereas children with cardiac surgery showed reduced plasma B7-H3 immediately after surgery and at day 3 after surgery (p?<?0.05). Plasma B7-H3 in cardiac surgery group was dropped much lower than that in general surgery group at day 1 (p?<?0.05) and day 3 (p?<?0.01) after surgery. Significantly reduced plasma B7-H3 was observed in the severe stress group, but not in the moderate stress group, immediately after surgery and at day 3 after surgery (p?<?0.05), and severe stress group had significantly lower plasma B7-H3 levels than moderate stress group at day 1, day 3, and day 7 after surgery (p?<?0.05). Furthermore, plasma B7-H3 levels at day 1 (p?=?0.01) and day 3 (p?=?0.025) after surgery correlated negatively with surgical stress scores. Conclusions: Plasma B7-H3 levels were decreased significantly in children subjected to pediatric general and cardiac surgery, which is closely associated with the severity of surgical stress. The negative correlation of plasma B7-H3 levels at day 1 and day 3 after surgery with surgical stress scoring implicates that the plasma B7-H3 level might be a useful biomarker for monitoring stress intensity during pediatric surgery.
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Keywords
Pediatric surgery , B7-H3 , Surgical stress , Children
Citation
Li, Y., Yuan, Q., Huang, J., Li, Y. P., Pan, J., Feng, X., Zhang, X. G., Wang, J. H. and Wang, J. (2016) 'Assessment of plasma B7-H3 levels in pediatric patients with different degrees of surgical stress', BMC Pediatrics, 16,110 (6pp). doi: 10.1186/s12887-016-0655-1