The effect of different anesthesia applications on serum Pentraxin-3 levels: a randomized prospective study The effects of anesthesia on pentraxin-3

Main Article Content

Hatice Betul Altinisik
Fatma Beyazit
Hakan Turkon


Objective: Pentraxin-3 (PTX3) is a biomarker shown to correlate with the severity of infections. It is a good indicator of mortality and is useful in monitoring treatment success. However, there is inadequate information about the factors affecting PTX3 levels. This study aimed to investigate the effects of different anaesthesia types on serum PTX3 levels.

Materials/Patients and Methods: Serum PTX3 levels were obtained from patients who were under general anaesthesia (GA) and spinal anaesthesia (SA) for a caesarean section (C-section). Blood Samples were collected preoperatively at 6 h and 24 h postoperatively. Biomarkers such as C-reactive protein, white blood cells, neutrophils and lymphocytes were also assessed as biomarkers.

Results: No difference was found in the preoperative serum PTX3 levels among the participants (p > 0.05). A significant increase was observed when the preoperative PTX3 levels (0.16 ng/mL) were compared with the postoperative levels at 6 h (0.25 ng/mL) and 24 h (0.54 ng/mL) in the GA group. No significant change was found in the PTX3 levels at 0–6–24 h measurements in the SA group. Nevertheless, the GA group was found to be significantly higher than the SA group at 6 h and 24 h postoperatively (p < 0.05). Additionally, No correlation was observed between PTX3 levels and other biomarkers.

Conclusions: This study showed that when coupled with C-section, GA increased the PTX3 levels postoperatively compared with the PTX3 levels during the preoperative period. No significant change was observed with SA. The PTX-3 levels should be considered to increase in association with GA in suspected infectious and inflammatory cases. Therefore, regional anaesthesia should be preferred.


Download data is not yet available.

Article Details

How to Cite
Altinisik, H. B., Beyazit, F., & Turkon, H. (2021). The effect of different anesthesia applications on serum Pentraxin-3 levels: a randomized prospective study. Medical Science and Discovery, 8(9), 520-525.
Research Article


1. Garlanda C, Bottazzi B, Salvatori G, De Santis R, Cotena A, Deban L. Pentraxins in innate immunity and inflammation. Novartis Found Symp 2006; 79: 80-86.

2. Doni A, Mantovani G, Porta C, Tuckermann J, Reichardt HM, Kleiman A. Cell-specific regulation of PTX3 by glucocorticoid hormones in hematopoietic and nonhematopoietic cells. J Biol Chem 2008; 283:29983-92.

3. Bottazzi B, Inforzato A, Messa M, Barbagallo M, Magrini E, Garlanda C. The pentraxins PTX3 and SAP in innate immunity, regulation of inflammation and tissue remodelling. J Hepatol 2016; 64(6): 1416-27.

4. Aksungur N, Ozogul B, Ozturk N, Arslan S, Karadeniz E, Korkut E. Prognostic importance of pentraxin 3 levels in acute cholesistitis. Ulus Travma Acil Cerrahi Derg 2015; 21: 380-384.

5. Locatelli M, Ferrero S, Martinelli Boneschi F, Boiocchi L, Zavanone M, Maria Gaini S. The long pentraxin PTX3 as a correlate of cancer-related inflammation and prognosis of malignancy in gliomas. J Neuroimmunol 2013; 260: 99-106.

6. Mauri T, Bellani G, Patroniti N, Coppadoro A, Peri G, Cuccovillo I. Persisting high levels of plasma pentraxin 3 over the first days after severe sepsis and septic shock onset are associated with mortality. Intensive Care Med 2010; 36: 621-29.

7. Usitalo-Seppala R, Huttunen R, Aittoniemi J, Koskinen P, Leino A, Vahlberg T. Pentraxin 3 (PTX3) is associated with severe sepsis and fatal disease in emergency room patients with suspected infection: a prospective cohort study. PLoS One 2013; 8(1): e53661.

8. Liu S, Qu X, Liu F, Wang C. Pentraxin 3 as a prognostic biomarker in patients with systemic inflammation or infection. Mediators Inflamm 2014; 421-29.

9. MStevenson GW, Hall SC, Rudnick S, Seleny FL, Stevenson HC. The effect of anesthetic agents on the human immune response. Anesthesiology 1990; 72: 542-52.

10. López-Andrade Jurado A, Almazán Duro A, Martín Ruiz JL, Samaniego Muñoz F, López-Andrade Jurado MA, del Campo Iglesias A. Immune response in the surgical patient: effect of anesthesia and blood transfusion. Rev Esp Anestesiol Reanim 2000; 47: 67-80.

11. Kilic R, Yasar MA, Avci L, Demirel I, Yasar D. The Effects of Using Epidural Anesthesia with General Anesthesia on Plasma Levels of Cytokins and Cortizol in Patients with Lower Abdominal Surgery. Firat Med J 2005; 10: 59-63

12. Bastrup-Birk S, Skjoedt MO, Munthe-Fog L, Strom JJ, Ma YJ, Garred P. Pentraxin-3 serum levels are associated with disease severity and mortality in patients with systemic inflammatory response syndrome. PLoS One 2013; 9:8(9):e73119.

13. Huttunen R, Hurme M, Aittoniemi J, Huhtala H, Vuento R, Laine J. High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study. PLoS One 2011; 10;6(3):e17653.
14. de Kruif MD, Limper M, Sierhuis K, Wagenaar JF, Spek CA, Garlanda C. PTX3 predicts severe disease in febrile patients at the emergency department. J Infect 2010; 60: 122-27.

15. Kleber C, Becker CA, Schmidt-Bleek K, Schaser KD, Haas NP. Are pentraxin 3 and transsignaling early markers for immunologic injury severity in polytrauma? A pilot study. Clin Orthop Relat Res 2013; 471: 2822-30.

16. Hamra JG, Yaksh TL. Halothane inhibits T cell proliferation and interleukin-2 receptor expression in rats. Immunopharmacol Immunotoxicol 1996; 18: 323-36.

17. Lewis RE Jr, Cruse JM, Hazelwood J. Halothane-induced suppression of cell-mediated immunity in normal and tumor-bearing C3Hf/He mice. Anesth Analg 1980; 59: 666-671.

18. Markovic SN, Knight PR, Murasko DM. Inhibition of interferon stimulation of natural killer cell activity in mice anesthetized with halothane or isoflurane. Anesthesiology 1993; 78: 700–06.

19. Homburger JA, Meiler SE. Anesthesia drugs, immunity, and long-term outcome. Curr Opin Anaesthesiol 2006; 19(4):423-28.

20. Matsuoka H, Kurosawa S, Horinouchi T, Kato M, Hashimoto Y. Inhalation anesthetics induce apoptosis in normal peripheral lymphocytes in vitro. Anesthesiology 2001; 95:1467-72.

21. Brand JM, Kirchner H, Poppe C, Schmucker P. The effects of general anesthesia on human peripheral immune cell distribution and cytokine production. Clin Immunol Immunopathol 1997; 83: 190-94.

22. Schneemilch CE, Ittenson A, Ansorge S, Hachenberg T, Bank U. Effect of 2 anesthetic techniques on the postoperative proinflammatory and anti-inflammatory cytokine response and cellular immune function to minor surgery. J Clin Anesth 2005; 17: 517-27.

23. Lippa S, De Sole P, Meucci E, Littarru GP, De Francisci G, Magalini SI. Effect of general anesthetics on human granulocyte chemiluminescence. Experientia 1983; 39: 1386-88.

24. Mitsuhata H, Shimizu R, Yokoyama MM. Suppressive effects of volatile anesthetics on cytokine release in human peripheral blood mononuclear cells. Int J Immunopharmacol 1995; 17(6): 529-34.

25. Kitamura T, Ohno N, Bougaki M, Ogawa M, Yamada Y. Comparison of the effects of sevoflurane and propofol on changes in leukocyte-count induced by surgical stress. Masui 2008; 57(8):968-72.

26. Cetin I, Cozzi V, Pasqualini F, Nebuloni M, Garlanda C, Vago L. Elevated maternal levels of the long pentraxin 3 (PTX3) in preeclampsia and intrauterine growth restriction. Am J Obstet Gynecol 2006; 194(5), 1347-53.

27. Kun L, Tang L, Wang J, Yang H, Ren J. Effect of Combined General/Epidural Anesthesia on Postoperative NK Cell Activity and Cytokine Response in Gastric Cancer Patients Undergoing Radical Resection. Hepatogastroenterology 2014; 61(132):1142-47.

28. Kaye AD, Patel N, Bueno FR, Hymel B, Vadivelu N, Kodumudi G. Effect of opiates, anesthetic techniques, and other perioperative factors on surgical cancer patients. Ochsner J 2014; 14(2): 216-28.