Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Relationship Between Interleukin-6 Production and Inflammatory Response during Cardiopulmonary Bypass

체외순환기 인터루킨-6의 생성과 염증반응간의 상관관계에 관한 연구

  • 박광훈 (인제대학교 의과대학 부산 백병원 흉부외과학교실) ;
  • 최석철 (인제대학교 의과대학 부산 백병원 흉부외과 체외순환 연구실) ;
  • 한일용 (인제대학교 의과대학 부산 백병원 흉부외과학교실) ;
  • 최국렬 (인제대학교 의과대학 부산 백병원 흉부외과학교실 체외순환 연구실) ;
  • 최강주 (인제대학교 의과대학 부산 백병원 흉부외과학교실) ;
  • 조광현 (인제대학교 의과대학 부산 백병원 흉부외과학교실)
  • Published : 2000.05.01
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Abstract

Background: With open heart surgery(OHS), it has been recognized that many postoperative complications and postperfusion syndrome are associated with the activations of complements and leulocytes. Recently, some investigators also demonstrated that interlukin-6(IL-6) linked highly with postperfusion syndrome. The puropose of this study was to investigate the sequential changes of the IL-6 and to clarify each IL-6 relationship to the complements(C3, C4) and inflammatory response following cardiopulmonary bypass(CPB). Material and Method: To determine serum levels of IL-6, complements, leukocytes, and biochemistric markers of liver and renal function, blood samples were taken from th radial artery in 30 adult patients undergoing OHS with CPB. Result: Serum IL-6 levels incrased significantly at 10 minutes after CPB-on(CPB-10) in comparison with the control levels and reached the peak at CPB-off(p<0.05). Serum complement levels declined rapidly at CPB-10 and remained at the lower levels during CPB(p<0.01). Sequential changes of IL-6 levels had positive correlations with the changes of total leukocytes and neutrophil fractions(p<0.05), but had negative correlations with lymphocyte fractions(p<0.05). Changes of C3 related postively to monocyte fractions(p<0.05). Postoperative levels of total protein and albumin, decreased significantly in comparison with the control levels(p<0.01), while the postoperative levels of AST(aspartate transaminase) and bilirubin increased (p<0.01). At CPB-off, IL-6 levels had negative correlations with total protein and albumin levels(r=-0.60, -0.47 respectively, p<0.05), whereas C3 levels had positive correlations with albumin levels(r=0.40, p<0.05). IL-6 levels, as well as neutrophil fractions, had positive correlations with aortic clamp time(ACT) and total bypass time(TBT) (IL-6; r=0.82, 0.79 respectively, neutrophil fractions; r=0.50, 0.56 respectively, p<0.05), wheres lymphocyte frations and albumin levels had negative correlations whith ACT and TBT(lymphocyte fractions; r=-0.52, -0.58 respectively, albumin; r=-0.58, -0.55 respectively, p<0.05). Conclusion: These data showed that elevated production of serum IL-6 during CPB may play a pivotal role in systemic inflammatory responses and prologed CPB period may be assosiated with more sever postperfusion syndromes.

Keywords

References

  1. Cardiovasc Clin v.17 Early complications following carciac surgery Kirklin JK;McGiffin DC
  2. N Eng J Med v.304 Complement activation during cardropulmonary bypass.evidence for generation of C3a and C5a anaphylatoxins Chcnoweth DE;Cooper SW;Hugli TE(et al)
  3. Arch Surg v.123 Effects of cardiopulmonary bypass on pulmonary leukostasis and compulement activation Howard RJ;Crain C;Franzini DA(et al)
  4. Ann Thorac Surg v.51 Prospects for understanding and elimnating the deleterious effects of cardiopulmonary bypass Kirklin JK
  5. J Thorac Cardiovasc Surg v.106 Cytokine and complement levels in patients undergoing cardiopulmonary bypass Steinberg JB;Kapelanski DP;Olson JD(et al)
  6. Science v.256 Negative inotropic effects of cytokines on the heart mediated by nitric oxide Finkel MS;Oddis CV;Jarcob TD(et al)
  7. J Thorac Cardiovasc Surg v.112 Myocardium is a major source of proinflammatory cytokines in patients undergoing cardiopulmonary bypass Wan S;DcSmet JM;Barvais L(et al)
  8. J Thorac Cardiovasc Surg v.108 Circulating cytokines in patients undergoing normothermic cardiopulmonary bypass Frering B;Philip I;Dehoux M(et al)
  9. J Thorac Cardiovasc Surg v.106 Cytokine and complement levels in patients undergoing cardiopulmonary bypass Steiberg JB;Kapelanski DP;Olson JD(et al)
  10. Circulation v.92 Steroid inhibition of cytokin-mediated vasoilation after warm heart surgery Teoh K;Brandely CA;Gauldie J(et al)
  11. Can J Ane v.40 Elevation of cytokines during open heart surgary with cadiopulmonary bypass: participation of interleukin 8 and 6 in reperfusion injury Kawamura T;Wakusawa R;Okada K(et al)
  12. Blood v.74 Blood: the biology of interleokin-6 Kishmoto T
  13. J Burn Care Rehabil v.15 The production of tumor necrosis fator, interleukin-1,interleukin-6 and prostaglandin E2 by isolated enterocytes and gut macrophages:effect of lipopolysaccharide and thermal injury Ogle CK;Mao J;Wu J(et al)
  14. J Clin Invest v.94 Alverolar typeⅡ epithelial cells produce interleukin-6 in vitro and vivo Crestani B;Comillet P;Dehoux M(et al)
  15. Tiansfusion v.94 Cytokine generation in stored platelet concentrates Stack G;Snyder EL
  16. Surgery v.111 Interleukin-6 as a new indicator of unflammatory status. detection of serum levels of interoeukin-6 and C-reactive protein after surgery Ohzato H;Yoshizaki K;Nishimoto N(et al)
  17. Circulation v.92 Induction of interleukin-6 synthesis in myocardium: potential role in postperfusion inflammatory injury Kukielka GL;Smith CW;Manning AM(et al)
  18. Am J Cardiol v.71 Interleukin-6(IN-6) as a madiator of stunned myocardium Finkel MS;Hoffman RA;Shen L(et al)
  19. Lancet v.2 Serum levels of interleulin 6 and acute phase responses Nijsten MW;DeGroot ER;Tenduis HJ(et al)
  20. J Cardiothorac Vasc Ane v.10 A study of the effects of extracorporeal circulation on the immunologic system of humans Siminelakis S;Bossinakou I;Antonius F(et al)
  21. Immunology(3rd ed) Roitt I;Brostoff J;Male D
  22. Circulation v.92 Steroid inhibition of cytokin-mediated vasoilation after warm heart surgery Teoh K;Brandely CA;Gauldie J(et al)
  23. Circulation(SuppⅡ v.92 Steroid inhibition of cytokin-mediated vasoilation after warm heart surgery Teoh K;Brandely CA;Gauldie J(et al)
  24. Circulation(suppⅡ) v.92 Steroid inhibition of cytokin-mediated vasoilation after warm heart surgery Teoh K;Brandely CA;Gauldie J(et al)
  25. Exp Cell Res v.209 An evaluation of the effects of cytokines on intracellular oxidative production in normal neutrophols by flow cytometry Yuan L;Inoue S;Saito Y(et al)
  26. Endocrinology v.131 IL-6 increases endothelial permeability in vitro Maruo N;Morita I;Shirao M(et al)
  27. J Clin Invest v.89 Neutrophil adherence to isolated adult cardiac myocytes:induction by cardiac lymph collected during ischemia and reperfusion Youker KA;Smith CW;Anderson DC(et al)
  28. Ann NY Acad Sci v.577 IFN β2/BSF2/IL-6 is the monocyte-derived HSF that regulates receptor-specific acute phase gene regulation in hepatocytes Gauldie J;Richards C;Northemann W(et al)
  29. Lancet(4th ed) Serum level of interleukin-6 and acute phase responses,Lancet(4th ed) Nijsten MW;De Groot ER;Ten Duit HJ(et al)