Interleukin-6 in transcatheter arterial embolization for patients with hepatocellular carcinoma. Effects of serine protease inhibitor

Abstract

Background. Modulation of serum levels of circulating cytokines and inflammatory responses with a serine protease inhibitor was studied in 34 patients with hepatocellular carcinoma (HCC) after transcatheter arterial embolization (TAE). Methods. The 34 patients were randomly divided into two groups: 17 patients received 500 mg gabexate mesilate, a serine protease inhibitor, intravenously twice a day for 5 days after TAE, and the remaining 17 patients did not receive the drug. Results. In the patients not given the drug, circulating interleukin‐6 (IL‐6) markedly increased 1 day after TAE, reached a peak (approximately 8 times the pretreatment value) after 4 days, and remained elevated 7 days after TAE. In comparison, in the patients given the drug, circulating IL‐6 was at a significantly lower level at 4 and 7 days after TAE (P < 0.05, respectively). Both groups did not show significant change in circulating interleukin‐1β (IL‐1β) and tumor necrosis factor alpha (TNFα) during the week after TAE. The drug also showed a tendency to keep patient temperature below 38°C, and the elevation of serum C‐reactive protein (CRP) concentration to less than 1 mg/dl after TAE (P < 0.05, respectively). Conclusions. The serum level of circulating IL‐6 can be modulated by serine protease inhibitor, and this may contribute to suppressing inflammatory responses, such as fever and acute‐phase protein synthesis, in the liver after TAE.