Effects of magnesium pretreatment on the levels of T helper cytokines and on the severity of reperfusion syndrome in patients undergoing living donor liver transplantation

Abstract

Objectives: Magnesium has protective effects in ischaemiareperfusion injury, and is involved in immunomodulation. We investigated the effects of magnesium pretreatment on the secretion of T helper (Th) cytokines and on the severity of post-reperfusion syndrome (PRS) in patients undergoing living donor liver transplantation (LDLT). Methods: forty patients were allocated to two groups of 20 (magnesium and saline groups). Blood samples for cytokine analysis were collected before infusion of the study solution at the end of anhepatic phase (time point 1), as well as five min and 30 min after allograft reperfusion (time points 2 and 3, respectively). Levels of cytokines were quantified using a sandwich enzyme immunoassay test kit. Results: The duration of PRS was shorter in the magnesium group (p = 0.038). The level of interferon (IFN)-␥ released from Th1 was lower in the magnesium group at time point 3 (p = 0.009). Of the cytokines released from Th2 cells, interleukin (IL)-6 was present in higher concentrations in the magnesium group at time points 2 and 3 (p<0.05). The concentrations of IL-4 and IL-10, which were secreted from Th2 cells, were also higher in the magnesium group at time point 3 (p<0.05). The IFN-␥ /IL-6, IFN-␥ /IL-4 and IFN-␥ /IL-10 ratios were lower in the magnesium group after allograft reperfusion. Conclusions: Magnesium pretreatment attenuated PRS and reinforced Th2 cell activity, shifting the Th1-to-Th2 cytokine balance towards Th2 in patients undergoing LDLT.

Increased Mortality Associated with Hypermagnesemia in Severe COVID-19 Illness

“…Few studies have attempted to investigate whether magnesium plays a role in outcomes in COVID-19, but all have methodological limitations ( e.g ., small sample size, not randomized, selection bias, and confounding) (12,13). There are also conflicting reports of the role magnesium homeostasis plays in the expression of IL-6 and other cytokines in non–COVID-19 critical illness, with some studies reporting the proinflammatory effect of hypomagnesemia leading to increased production of IL-1β, IL-6, and TNF-α and PAI-1 (11,14,15), whereas one study reported patients treated with magnesium had lower levels of TNF-α, but higher levels of IL-6, IL-4, and IL-10 (16). Unfortunately, there were too few patients in our cohort with available cytokine levels (in particular IL-6) to make any meaningful conclusions about the association with magnesium.…”

Factors associated with the elevated percentage of CD4CD69 T cells in maintained hemodialysis patients

“…Moreover, the magnesium transporter protein 1 could be a new intermediate in TCR signaling, which is linked to T-cell deficiency when mutated [ 42 , 43 ]. Further studies showed that magnesium would regulate the secretion of cytokine of CD4 helper T lymphocytes to change the inflammatory status of the organism [ 44 , 45 ]. Therefore, reducing the concentration of transferrin and magnesium may contribute to the reduction of activated CD4 T cells theoretically.…”

Immune response associated with ischemia and reperfusion injury during organ transplantation

“…One experiment shows that in IFN-γ knockout mice, renal IRI is more severe than that in the control group [ 105 ]. It has been demonstrated that magnesium pretreatment improves reperfusion syndrome and enhance Th2 cell activity, with increased IL-4 and IL-10, causing a shift in Th1-Th2 cytokine balance to Th2 in patients undergoing liver transplantation [ 106 ]. MicroRNA-155 deficiency reduces IRI in mice after liver transplantation, which is related to the reduction of IL-17 secretion caused by inhibition of Th17 differentiation [ 107 ].…”