The changes of dynorphin in the peripheral white blood cells and plasma of diabetic patients during the perioperative period

Objective To investigate the changes of dynorphin A (DYN-A) in plasma and derived from peripheral white blood cells (WBCs) of diabetic patients during the perioperative period. Methods Patients scheduled for posterior lumbar interbody fusion (PLIF) under general anesthesia were selected and divided into two groups: a non-diabetes group (an NDM group, n=49) and a diabetes group (a DM group, n=23). The total number of peripheral WBCs and their classification such as lymphocytes, monocytes, and granulocytes were counted before and after operation. Before anesthesia (T1), and after awakening from anesthesia (T2), blood samples from the non-infusion sided elbow vein were collected. The plasma levels of DYN-A were measured by enzyme-linked immunosorbent assay(ELISA). Flow cytometry (FCM) was used to determine the percentage of DYN-A fluorescence positive cells and mean fluorescence intensity (MFI) of WBCs. Results In the NDM group, the total number of peripheral WBCs at T2 [(12.9±4.1)×109/L] was remarkably higher than the count at T1 [(6.3±1.6)×109/L](P 0.05). Conclusions The total number of peripheral WBCs significantly increases in the diabetic patients during the perioperative period, with the most obvious increase in granulocyte count. The percentage of DYN-A positive cells in leukocyte classification significantly decreases, while the level of DYN-A in plasma and derived from granulocytes also decreases. These changes are related to the perioperative stress and immune status of the diabetic patients. Key words: Diabetes; Perioperative period; White blood cell; Dynorphin