[Measurement of cytokines at cardiopulmonary-bypass]
1First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Insights
Cardiac surgery using cardiopulmonary bypass significantly elevates inflammatory markers like Interleukin-6 (IL-6) and Interleukin-8 (IL-8). These cytokine increases correlate with bypass duration and indicate tissue damage, with IL-8 linked to Granulocyte Elastase release.
Area of Science:
- Biomedical Science
- Surgical Research
- Inflammation and Immunology
Context:
- Cardiac surgery frequently involves cardiopulmonary bypass (CPB).
- CPB can trigger systemic inflammatory responses.
- Monitoring inflammatory markers is crucial for assessing surgical impact.
Purpose:
- To measure levels of specific cytokines and enzymes (TNF-alpha, IL-1 beta, IL-6, IL-8, GEL) in patients undergoing cardiac surgery with CPB.
- To evaluate the relationship between these markers and CPB duration.
- To determine if these markers indicate tissue damage post-surgery.
Summary:
- Levels of Tumor Necrosis Factor alpha and Interleukin-1 beta were minimally detected, primarily in prolonged CPB cases (>250 min).
- Interleukin-6 and Interleukin-8 levels significantly increased immediately after CPB compared to pre-operative levels, correlating with CPB time.
- Granulocyte Elastase also showed a significant increase post-CPB, correlating with IL-8 levels, suggesting IL-8's role in GEL-mediated cytopathogenicity.
Impact:
- Cytokine measurements serve as valuable indicators of tissue damage following cardiac surgery.
- Findings highlight the inflammatory burden associated with CPB.
- The study suggests a specific mechanism involving IL-8 and GEL in post-surgical tissue injury.
Abstract:
Tumor Necrosis Factor alpha (TNF-alpha), Interleukin 1 beta (IL-1 beta), Interleukin 6 (IL-6), Interleukin 8 (IL-8), and Granulocyte Elastaze (GEL) were measured in twenty-five patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). These levels were measured before and immediately after CPB, on the first, the third, and the sixth operative days. According to results, TNF-alpha and IL-1 beta were detected only three of the twenty-five patients with CPB more than 250 minutes. The IL-6 level that was 29.93 +/- 6.73 pg/ml before CPB peaked at 1417.81 +/- 149.81 pg/ml immediately after CPB. IL-8 (2.92 +/- 1.65 pg/ml) peaked at 36.73 +/- 35.52 pg/ml (p < 0.01) after immediately CPB. There were statistically significant differences in the IL-6 and IL-8 between levels before and immediately after CPB (p < 0.01). The GEL level increased from 181.41 +/- 128.98 micrograms/L before CPB to 2182.57 +/- 1757.25 micrograms/L immediately after CPB, with significant difference (p < 0.01). IL-6 and IL-8 levels correlated significantly with the time of CPB (r = 0.612, p < 0.01, r = 0.707, p < 0.001, respectively). In addition, the GEL levels significantly correlated with IL-8 level at each time of CPB (r = 0.733, p < 0.001). This study demonstrated that measurements of cytokines are good indicators of tissue damage for cardiac surgery and also indicates cytopathogenicity of IL-8 is due to GEL.
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