Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Sequential changes of Interleukin-6, Tumor Necrosis Factor-$\alpha$, and Troponin-T During Open Heart Surgery with Cardiopulmonary Bypass

체외순환을 이용한 심장수술시 혈청 Interleukin-6, Tumor Necrosis Factor-$\alpha$와 Troponin-T의 시간대별 변화

  • 류지윤 (인제대학교 의과대학 부산 백병원 흉부외과학교실) ;
  • 최석철 (인제대학교 의과대학 부산 백병원 흉부외과학교실) ;
  • 곽기오 (인제대학교 의과대학 부산 백병원 흉부외과학교실) ;
  • 최국렬 (인제대학교 데이터정보학과) ;
  • 김송명 (고신대학교 의과대학 부속 고신의료원 흉부외과학교실) ;
  • 조광현 (인제대학교 의과대학 부산 백병원 흉부외과학교실)
  • Published : 1999.11.01
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Abstract

Background: Immunologic and inflammatory responses of cardiopulmonary bypass(CPB) influence postoperative mortality and morbidity with multiple organ injury. It has been reported that ischemia/reperfusion induced-myocardial injury during CPB is causative of release of inflammatory cytokines such as interleukin-6(IL-6) and tumor necrosis factor-$\alpha$ (TNF-$\alpha$). The purpose of this study was to detect the time course of the activated cytokine and troponin-T(TnT), and to examine the correlation between such parameters during CPB. Material and Method: The serial samples were collected from arterial blood via radial arterial catheter in 23 patients who are underwent open heart surgery (OHS) with CPB, the IL-6, TNF-$\alpha$ and TnT were checked. Result: \circled1 IL-6, TNF$\alpha$- and TnT concentration increased significantly during CPB with a peaking level of CPB-off (p 0.05). \circled2 IL-6 had highly positive correlation with aortic cross clamping time and total bypass time(r=0.80, 0.78; p 0.05, respectively). \circled3 There was no correlation among IL-6, TNF-$\alpha$ and TnT. Conclusion: In conclusion, these data showed that elevated production of serum IL-6 during CPB was attributable to ischemia/reperfusion induced-myocardial damage. IL-6 will become a new and sensitive biological marker in assessment of myocardial damage during OHS with CPB. However, further studies will be needed to apply IL-6 in more patient population.

Keywords

References

  1. J Thorac Cardiovasc Surg v.112 Myocardium is a major source of proinflammatory cytokine in patients undergoing cardiopulmonary bypass Wan S;DeSmet JM;Barvais L(et al.)
  2. Am Heart J v.113 Cardiac specific troponin-T radioimmunoassay in the diagnosis of acute myocardial infarction. Cummins B;Auckland MI;Cummins P
  3. Ann Thorac Surg v.55 Inflammatory response to cardiopulmonary bypass Butler J;Rocker GM;Westaby S
  4. J Exp Med v.168 C5astimulates secretion of tumor necrosis factor from human mononuclear cells in vitro Comparison with secretion of IL-1β and IL-1α Okusawa S;Yancey KB;Vander Meer JWM(et al)
  5. J Exp Med v.171 The role of cytokines in the generation of inflammation and tissue damage in experimental gram positive meningitis Saukkonnen K;Sande S;Cioffc C(et al.)
  6. Ann Thorac Surg v.54 Endotoxin release and tumor necrosis factor formation during cardiopulmonary bypass Jansen JGJ;van Overen W;Gu YJ(et al.)
  7. J Clin Invest v.78 Cachecun/tumor necrosis factor regulates hepatic acute phase gene expression Permutter DH;Dinarello CA;Punsal PI(et al.)
  8. Am Rev Respir Dis v.141 Plasma tumor necrosis factor in patients with septic shock: mortality rate, incidence of adult respiratory distress syndrome, and effects of methylprednisolone administration Marks, JP;Marks CB;Lucc M(et al.)
  9. J Immunol v.136 Stimulation of neutrophils by tumor necrosis factor Klebanoff S;Vadas MA;Harlan JM(et al.)
  10. J Thorac Cardiovasc Surg v.102 Inhibition by dexamethasone at the reperfusion phenomena in cardiopulmonary bypass Jansen NJG;van Oeveran W;Broek LVD(et al.)
  11. J Thorac Cardivasc Surg v.105 no.1 Effect of cardio-pulmonary bypass on systemic release of neutrophilelastase and tumor necrosis factor Butler J;Parker D;Pillai R(et al.)
  12. Eur J Immunol v.18 Induction of ratacute phase proteins by interleukin-6 in vivo Gieger T;Andus T;Klapproth J(et al.)
  13. J Immunol v.142 Interleukin-1 stimulare interleukin-6 production in endothelial cells Sironi M;Breviario F;Proserpio P(et al.)
  14. Clin Sci v.79 Response of serum interleukin-6 in patients undergoing elective surgery of varing severity Cruickshank AM;Fraser WD;Burns HJG;Van Damme J;Shenkin A
  15. Interleukin-6: An overview Ann Rev Immunol v.8 Van SJ
  16. Ann Thorac Surg v.53 Cytokine responses to cardiopulmonary bypass with membrane and bubble oxygenation Butler J;Chong GL;Baigrie RJ(et al.)
  17. J Thorac Cardiovasc Surg v.106 Cytokine and complement levels in patients undergoing cardiopulmonary bypass Steingerg JB;Kapelanski DP;Olson JD(et al.)
  18. Can J Anaesth v.40 Elevation of cytokines during open heart surgery with cardiopulmonary bypass: parncipation of interleukin-6 and 8 in reperfusion injury Takae K;Reiji W;Kazutoshi O;Shoya I
  19. Circulation v.92 Induction of interleukin-6 synthesis in the myocardium Gilbert LK;Wayne S;Anthony MM;Keith AY;Lloyd HM;Mark LE
  20. Ann Thorac Surg v.60 Influence of steroids on complement and cytokine generation after cardiopulmonary bypass Engelman RM;Rousou JA;Flack III JE(et al.)
  21. J Mol Cell Cardiol v.21 Enzyme-linked immunoassay of cardiac troponin-T for detection of acute myocardial infarction in patients Katus HA;Remppis A;Looser S;Hallermeier K;Scheffold T;Kubler W
  22. Clin Chem v.38 Development and in virto characterization of a new immunoassay of cardiac troponin-T Katus HA;Looser S;Hallermayer(et al.)