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Methylprednisolone, cortisol and the cell-mediated immune response in children after ventricular septal defect repair

Stefan Grosek1, Alojz Ihan, Branka Wraber

  • 1Department of Paediatric Surgery and Intensive Care, University Medical Centre Ljubljana, Zaloska 7, Ljubljana, Slovenia. stefan.grosek@mf.uni-lj.si

Clinical Chemistry and Laboratory Medicine
|October 11, 2007
PubMed

Insights

Methylprednisolone did not significantly alter cortisol or immune cell levels in children undergoing heart surgery. Cardiac index influenced T-lymphocyte and monocyte responses, suggesting non-steroid factors modulate immune function post-cardiopulmonary bypass.

Area of Science:

  • Pediatric Cardiology
  • Immunology
  • Pharmacology

Background:

  • Open-heart surgery with cardiopulmonary bypass (CPB) can impact immune function.
  • Methylprednisolone is used in pediatric cardiac surgery, but its effects on immune response require further investigation.

Purpose of the Study:

  • To evaluate the impact of methylprednisolone on cortisol and cell-mediated immunity (T-lymphocytes, HLA-DR+ monocytes) in children post-ventricular septal defect repair.
  • To explore the relationship between cardiac index (CI) and these immune parameters after surgery.

Main Methods:

  • Prospective observational study in a pediatric intensive care unit.
  • Ten children under 2 years received methylprednisolone succinate during CPB.
  • Immune cell counts (flow cytometry) and plasma levels of methylprednisolone, cortisol (LC-MS) were measured pre- and post-surgery.

Main Results:

  • No significant differences in methylprednisolone or cortisol levels were observed between normal and low CI groups.
  • The normal CI group showed a significant decrease in T-lymphocytes at 24 hours and HLA-DR+ monocytes immediately post-surgery.
  • Low CI group data was not detailed in results, but differences were noted in immune cell responses between groups.

Conclusions:

  • T-lymphocytes and HLA-DR+ monocytes can differentiate children with normal versus low CI post-cardiac surgery.
  • Methylprednisolone exposure and cortisol levels did not differ between CI groups, suggesting other factors influence the cell-mediated immune response.
Abstract

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