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Cytokine Response to Fetal Cardiac Bypass
Reddy1, McElhinney, Rajasinghe
1Division of Cardiothoracic Surgery, University of California, San Francisco, California
Journal of Maternal-Fetal Investigation : the Official Journal of French Society of Ultrasound in Medicine and Biology ... [Et Al.]
|December 16, 1998
Summary
Fetal cardiac bypass significantly increases interleukin-6 (IL-6) levels in fetal sheep. This rise in IL-6 correlates with reduced placental blood flow and increased placental vascular resistance, suggesting a role in placental dysfunction.
Area of Science:
- Cardiovascular Surgery
- Neonatal Physiology
- Immunology
Background:
- Systemic inflammatory response syndrome (SIRS) is linked to cardiopulmonary bypass.
- Placental dysfunction complicates fetal cardiac bypass.
- Cytokines may mediate acute phase reactions in placental dysfunction.
Purpose of the Study:
- To investigate the effect of fetal cardiac bypass on interleukin-1beta (IL-1beta), IL-6, and IL-8 in fetal sheep.
- To test the hypothesis that placental dysfunction after fetal cardiac bypass is cytokine-mediated.
Main Methods:
- Nine pregnant ewes underwent either fetal cardiac bypass (n=5) or sham procedure (control, n=4).
- Placental and systemic hemodynamics were monitored.
- Pre- and post-bypass blood samples were analyzed for IL-1beta, IL-6, and IL-8 using enzyme-linked immunosorbent assays.
Main Results:
- Interleukin-6 (IL-6) levels increased significantly in the fetal cardiac bypass group post-procedure (53.0 +/- 24.2 pg/ml) but remained undetectable in controls.
- No significant changes in IL-1beta or IL-8 were observed in either group.
- Fetal cardiac bypass led to a 23% decrease in placental blood flow and a 20% increase in placental vascular resistance, significantly more than in controls.
Conclusions:
- Fetal cardiac bypass causes significant increases in fetal plasma IL-6.
- Elevated IL-6 correlates with impaired placental blood flow and increased placental vascular resistance.
- IL-6 may play a role in placental dysfunction or serve as a marker of placental injury after fetal cardiac bypass.