Assessment of plasma B7-H3 levels in pediatric patients with different degrees of surgical stress
Li, Yi Ping
Zhang, Xue Guang
Wang, Jiang Huai
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.
Pediatric surgery , B7-H3 , Surgical stress , Children
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
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