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Changes in the cytokine network and complement parameters during open heart surgery.

Ivar Risnes1, Thor Ueland, Runar Lundblad

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Cardiopulmonary bypass (CPB) triggers a complex immune response. Initial CPB phases show a rise in anti-inflammatory interleukin-10 (IL-10) and inflammatory chemokines, not just pro-inflammatory cytokines.

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Area of Science:

  • Immunology
  • Cardiovascular Surgery

Background:

  • Cardiopulmonary bypass (CPB) induces a systemic inflammatory response.
  • The balance of inflammatory and anti-inflammatory mediators post-CPB is not fully understood.

Purpose of the Study:

  • To investigate the cytokine network complexity after CPB.
  • To analyze the balance between interleukin-10 (IL-10) and inflammatory cytokines/chemokines.

Main Methods:

  • Blood samples collected from 20 patients undergoing CPB.
  • Plasma levels of cytokines and complement activation markers analyzed pre- and post-CPB.

Main Results:

  • Initial phase post-CPB showed increased IL-10 and inflammatory chemokines (IL-8, MCP-1).
  • Tumor necrosis factor-alpha increase was modest; IL-6 remained elevated.
  • Complement activation increased immediately post-CPB, returning to baseline on day one.

Conclusions:

  • CPB induces a complex cytokine and complement response.
  • The early phase post-CPB is characterized by a significant rise in anti-inflammatory IL-10, unlike infection responses.