Transient rise in serum cytokines during coronary artery bypass graft surgery
T Fujiwara1, N Seo, T Murayama
1Department of Anesthesia and Intensive Care, Omiya Medical Center, Jichi Medical School, Japan.
Insights
Monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), and interleukin-6 (IL-6) levels significantly increased during coronary artery bypass graft (CABG) surgery, suggesting a systemic response. These cytokines were elevated in complicated cases, indicating their potential role in adverse outcomes.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Biochemistry
Background:
- Coronary artery bypass graft (CABG) surgery involves significant physiological stress.
- Cytokine profiles are crucial for understanding inflammatory responses post-surgery.
- The specific cytokine changes during CABG are not fully elucidated.
Purpose of the Study:
- To investigate the specificity of cytokine production during CABG surgery.
- To measure serum levels of key inflammatory cytokines, including MCP-1, IL-8, IL-6, IL-1 beta, and TNF.
- To correlate cytokine levels with surgical complications.
Main Methods:
- Serial measurement of serum cytokine levels (MCP-1, IL-8, IL-6, IL-1 beta, TNF) in 20 patients undergoing CABG.
- Sampling occurred during surgery and 2 days post-surgery.
- Cytokine concentrations were analyzed from blood samples taken from different vascular sites.
Main Results:
- Serum levels of MCP-1, IL-8, and IL-6 significantly increased during CABG (P < 0.05).
- IL-1 beta and TNF levels did not show significant changes.
- Elevated MCP-1, IL-8, and IL-6 levels were observed in patients with surgical complications, with higher peaks and longer persistence.
Conclusions:
- MCP-1, IL-8, and IL-6 exhibit a synchronized and systemic increase during CABG, suggesting a common underlying stimulus.
- The parallel increase of these cytokines across different vascular sites supports a systemic inflammatory response.
- The heightened and prolonged elevation of MCP-1, IL-8, and IL-6 in complicated cases highlights their potential role in adverse surgical outcomes.
Abstract:
In order to examine the specificity of cytokine production during coronary artery bypass graft (CABG) surgery, we serially measured serum levels of monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta) and tumor necrosis factor (TNF), in twenty patients between 52 and 80 years of age, during surgery and 2 days afterwards. Serum MCP-1, as well as IL-8 and IL-6, increased significantly during the surgery (P < 0.05), while IL-1 beta and TNF did not. MCP-1, IL-8 and IL-6 concentrations were not different in the sera of three patients tested at three different sites, i.e., the hepatic vein, pulmonary artery and radial artery. They increased in parallel in each patient, although the actual timing of the increase relative to the surgical step varied among individuals. In complicated patients, MCP-1, IL-8 and IL-6 showed higher peaks and persisted longer than in patients without complications. The universal and simultaneous appearance of MCP-1, IL-8 and IL-6 could indicate that these three cytokines may be stimulated by a yet undiscovered stimulus (or stimuli) which occurs systemically despite the independent pathways of production.
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