Genetic predisposition in patients undergoing cardiopulmonary bypass surgery is associated with an increase of inflammatory cytokines

Drabe, Natalie; ZundZünd, Gregor; GrunenfelderGrünenfelder, Jürg; Sprenger, Martin; Hoerstrup, Simon P.; Bestmann, Lukas; Maly, Friedrich E.; Turina, Marko

doi:10.1016/s1010-7940(01)00842-9

Cited by 31 publications

(27 citation statements)

References 16 publications

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“…Two studies have shown that carriers of the APO⑀4 allele have an increased inflammatory response to cardiopulmonary bypass (22,46), which may explain the increase in neurologic morbidity in this patient population (47). apoE may also play a particularly important role in mediating the inflammatory response to central nervous system injury (17,36), consistent with clinical observations associating the APO⑀4 allele with poor neurologic outcomes in patients with a variety of acute traumatic and ischemic brain injuries (21,48,49).…”

Section: Discussionsupporting

confidence: 57%

APOE polymorphism is associated with risk of severe sepsis in surgical patients*

Moretti

Morris

Podgoreanu

et al. 2005

Critical Care Medicine

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Section: Discussionsupporting

confidence: 57%

APOE polymorphism is associated with risk of severe sepsis in surgical patients*

Moretti

Morris

Podgoreanu

et al. 2005

Critical Care Medicine

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“…Nevertheless, limited data in humans show an effect of apoE genotype on pro-and anti-inflammatory cytokines independently of any exogenous source of experimental inflammation inducer. In a study of patients undergoing cardiopulmonary bypass surgery, a process that induces a transient rise in pro-inflammatory cytokines mainly released by activated monocytes, it was shown that apoE4 was associated with increased IL8 and TNFa [82]. In patients with acute coronary syndrome, significant lower levels of the anti-inflammatory IL10 were observed in e4 carriers, with the same trend evident in chronic stable angina patients [83].…”

Section: Inflammation In Relation To Cvdmentioning

confidence: 97%

Impact of apoE genotype on oxidative stress, inflammation and disease risk

Jofre-Monseny

Minihane

Rimbach³

2008

Molecular Nutrition Food Res

266

215

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Although in developing countries an apolipoprotein E4 (apoE4) genotype may offer an evolutionary advantage, as it has been shown to offer protection against certain infectious disease, in Westernised societies it is associated with increased morbidity and mortality, and represents a significant risk factor for cardiovascular disease, late-onset Alzheimer's disease and other chronic disorders. ApoE is an important modulator of many stages of lipoprotein metabolism and traditionally the increased risk was attributed to higher lipid levels in E4 carriers. However, more recent evidence demonstrates the multifunctional nature of the apoE protein and the fact that the impact of genotype on disease risk may be in large part due to an impact on oxidative status or the immunomodulatory/anti-inflammatory properties of apoE. An increasing number of studies in cell lines, targeted replacement rodents and human volunteers indicate higher oxidative stress and a more pro-inflammatory state associated with the epsilon4 allele. The impact of genotype on the antioxidant and immunomodulatory/anti-inflammatory properties of apoE is the focus of the current review. Furthermore, current information on the impact of environment (diet, exercise, smoking status, alcohol) on apoE genotype-phenotype associations are discussed with a view to identifying particular lifestyle strategies that could be adapted to counteract the 'at-risk' E4 genotype.

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“…To date, studies examining associations between surgery and delirium have investigated microemboli migration [149][150][151], hypoperfusion [64,137,[152][153][154], inflammatory responses [155][156][157], changes in hormone levels [158][159][160][161], and local and general anesthesia [64,133,162,163]. Gottesman and colleagues [152] hypothesized that a drop in the mean arterial pressure may put patients at risk for early cognitive dysfunction.…”

Section: Surgical Factors and Postoperative Cognitive Dysfunctionmentioning

confidence: 99%