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Stem cells mobilization by cardiopulmonary bypass after coronary artery bypass grafting
Adam R Kowalówka1, Wojciech Wojakowski2, Ryszard Bachowski1
1Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland.
Insights
Coronary artery bypass surgery using cardiopulmonary bypass did not mobilize stem and progenitor cells. Perioperative inflammation, not bypass, influenced cell expression, with diabetes inhibiting release.
Area of Science:
- Cardiovascular Surgery
- Regenerative Medicine
- Immunology
Background:
- Inflammatory reactions following organ damage can trigger stem and progenitor cell mobilization.
- Coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) induces an inflammatory response.
- This inflammatory response may influence the mobilization of regenerative cells.
Purpose of the Study:
- To investigate the impact of CPB on stem and progenitor cell mobilization in patients undergoing CABG.
- To correlate cell mobilization patterns with perioperative inflammatory responses.
Main Methods:
- Study included 20 patients scheduled for CABG.
- Peripheral blood samples collected perioperatively (pre-surgery, pre-CPB, CPB weaning, 24h post-op, 6th day post-op).
- Immune-labelled cell populations (HSC, MSC, EPC, VSEL) analyzed using ImageStream (IS).
Main Results:
- CPB did not induce mobilization in any isolated stem and progenitor cell lines (p > 0.05).
- Stem and progenitor cell expression correlated with the inflammatory reaction to traumatic stress.
- Type 2 diabetes was associated with hampered mesenchymal stem cell (MSC) mobilization.
Conclusions:
- Stem and progenitor cell mobilization was not directly related to CPB.
- Perioperative inflammation, not CPB, was linked to cell expression changes.
- Cell release was notably inhibited in patients with diabetes.
Introduction:
Expression of haematopoietic stem and progenitor cells occurs as a result of an inflammatory reaction caused by a damaged organ. Patients undergoing coronary artery bypass surgery (CABG) using cardiopulmonary bypass (CPB) are exposed to an inflammatory reaction, which may be a trigger in the mobilization of regenerative cells.
Aim:
To assess the impact of CPB on stem and progenitor cells mobilization in patients scheduled for CABG.
Material And Methods:
Twenty patients with stable coronary disease, who were scheduled for CABG, were included in the study. Peripheral blood samples were collected perioperatively: 2 h before surgery, before CPB, at CPB weaning, 24 h postoperatively, and on the 6th postoperative day. Analyses of immune-labelled cells were carried out on an ImageStream (IS) system.
Results:
The following cell populations were identified during cardiac surgery: haematopoietic stem cells (HSC), mesenchymal cells (MSC), endothelial progenitors (EPC), and very small embryonic-like cells (VSEL). The profile of cell mobilization coincides with the perioperative inflammatory response. Mobilization of stem and progenitor cells induced by CPB did not occur in any of the isolated cell lines (p > 0.05). The expression profile of stem and progenitor cells was related with the inflammatory reaction associated with traumatic stress in all cell lines. Type 2 diabetes is a disease that is hampering the trend of MSC mobilization.
Conclusions:
Mobilization of haematopoietic stem and progenitor cells was not related with CPB. The inflammatory reaction was associated with perioperative trauma. Cell release was inhibited in patients with diabetes.
