Leukocyte activation and phagocytotic activity in cardiac surgery and infection

Rothenburger, Markus; Trösch, Frank; Markewitz, Andreas; Berendes, Elmar; Schmid, Çhristof; Scheld, H. H.; Tjan, T. D. T.

doi:10.1016/s0967-2109(02)00016-9

Cited by 19 publications

(14 citation statements)

References 20 publications

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“…The canine and human cardiovascular profile is remarkably similar in sepsis, and the sphingomyelin pathway is believed to play a central role in TNFα-induced myocardial depression in both species. In addition, these highly specialized immune processes are not surprisingly of outmost interest in thoracic surgery, as a systemic inflammatory response syndrome (SIRS) due to cellular and humoral defense reactions are activated in cardiac surgery using cardiopulmonary bypass [96]. A line of research has focused on the innate immune response associated with open heart surgery and cardiac transplantation.…”

Section: The Heart As An Immunological Organmentioning

confidence: 99%

Innate immunity and inflammation — New frontiers in comparative cardiovascular pathology

Linde

Mosier

Blecha

et al. 2007

Cardiovascular Research

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Innate immunity and inflammation play key roles in a wide range of pathology - including heart disease and vasculopathies. Current thinking suggests "damage" rather than "foreignness" as the actual trigger of the immune system, which has caused a dramatic change in how we tend to view the etiopathology of most types of heart disease. The future potential of certain anti-inflammatory therapeutic strategies in addressing heart disease is intriguing. Still, the Janus face of immunity/inflammation cannot be over emphasized as adverse manipulation of these systems may prove ineffectual or worse, damaging. Knowledge on functional characteristics of individual immune mediators is undoubtedly a central theme, but in depth understanding of the multiple biological actions of these molecules, as well as their contextual function, is the corner stone in deciding on potential future targets for pharmacologic manipulation. Animal models of human heart disease are currently being investigated and clinical trials conducted to gain further knowledge in this essential area of cardiovascular research, but the scarcity of cardiovascular research focusing on signaling molecules and pathways of innate immunity is still evident. Genomic and proteomic research in heart disease is going through its formative years, and much is still unknown about the complex pathway dynamics utilized by the innate immune system. This review will provide an overview of the current literature focusing on innate immunity and the heart, and hopefully will spark an interest in further basic as well as clinical research. As more information on cardiovascular immunity becomes available, this will provide a better understanding and thus act as the foundation for potential development of new treatment strategies for treatment of cardiovascular disorders.

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Section: The Heart As An Immunological Organmentioning

confidence: 99%

Innate immunity and inflammation — New frontiers in comparative cardiovascular pathology

Linde

Mosier

Blecha

et al. 2007

Cardiovascular Research

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show abstract

“…On the other hand, the trauma derived from the surgical procedure -sternotomy itself also has pro inflammatory effect. The activation of inflammatory system, during either vascular or noncardiac thoracic surgery, was less marked than that of cardiopulmonary bypass (Rothenburger et al 2002).…”

Section: Discussionmentioning

confidence: 85%

“…The interaction between the human body and the cardiopulmonary bypass apparatus is very complex and involves several oxidative stress sources (Edmunds 1998), which may increase the activity of antioxidants. Conversion of pulsatile flow to laminar flow, direct contact of the blood with the artificial bypass surface, global cold ischemia with cardioplegic protection, hypothermia, activation of some proteins by the operation itself, aortic cross-clamping time, and myocardial reperfusion affect the magnitude of inflammatory response comprising the activation of endothelial cells as well as leucocytes (Hiesmayr et al 1999;Rothenburger et al 2002), platelets (Rothenburger et al 2002), the complement system (Chenoweth et al 1981) and the coagulation cascade (Despotis and Joist 1999). The production of oxygen free radicals and adhesion molecules and alterations in intracellular Ca 2+ handling appear to cause further damage in ischemic myocardium (Braunwald and Kloner 1985;Kloner 1993;Sheridan et al 1996).…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting Ameliorates the Decreased Plasma Adiponectin Level in Atherosclerotic Patients

Eyileten

Yılmaz

Kaya³

et al. 2007

Tohoku J. Exp. Med.

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Adiponectin functions as an anti-inflammatory and antiatherogenic factor, and the decreased plasma adiponectin is a risk factor for coronary disease. The aim of this study was to determine the changes in plasma levels of adiponectin, a potential parameter for atherosclerosis, in patients underwent surgical revascularization. We included forty patients with atherosclerosis (age, 58 ± 9 years; body mass index [BMI] 26.93 ± 2.3 kg/m 2 ) undergoing coronary artery bypass grafting (CABG). Control group consisted of 40 healthy volunteers, matched for age, gender and BMI (age, 56 ± 6 years; BMI, 26.78 ± 2.3 kg/m 2 ). We measured various parameters, including high sensitive Creactive protein (hsCRP), homeostasis model assessment-insulin resistance (HOMA-IR) indexes, and adiponectin. The baseline profile of the patients before CABG showed higher levels of serum hsCRP (13.15 ± 2.40 mg/l vs 3.97 ± 1.07 mg/l) and HOMA-IR (1.86 ± 0.30 vs 1.26 ± 0.33) and lower plasma adiponectin levels (7.02 ± 2.01 μ g/ml vs 25.46 ± 3.9 μ g/ml), compared to controls ( p < 0.001 for each parameter). Plasma adiponectin level was increased one month after CABG from the baseline level to 8.67 ± 2.05 μ g/ml ( p < 0.001), although the level was still lower than the control value. Thus, postoperative adiponectin level might be helpful for evaluating the progression of atherosclerosis. Moreover, CABG significantly decreased hsCRP to 7.25 ± 1.89 mg/l and HOMA-IR to 1.59 ± 0.33, although these levels were higher than the controls. These results suggest that CABG decreases the cardiac risk factors in atherosclerotic patients.adiponectin; coronary artery bypass grafting; insulin sensitivity; oxidative stress

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“…The inflammatory response produced by cardiothoracic surgery has been well known for many years; it is due to exposure of blood to non - physiologic surfaces and it occurs in cases in which CPB is applied (1, 3, 4). White blood cell (WBC) count increases as a part of inflammatory response cascade (1, 5, 6).…”

Section: Introductionmentioning

confidence: 99%

Normal Reference Interval of WBC Count After On - Pump Coronary Artery Bypass Graft; When Values Could Be Misleading

et al. 2018

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BackgroundApplying the cardiopulmonary pump produces inflammatory responses and induces leukocytosis. White Blood Cell (WBC) count has a diagnostic value for detecting different infections. In this study, we want to redefine the normal value reference intervals of WBC count in Coronary Artery Bypass Graft (CABG) patients, to prevent misdiagnose leukocytosis as a sign of infection.MethodsIn an observational study, 140 patients who underwent on - pump CABG were enrolled to find out normal values of the reference interval. WBC counts were evaluated for all of them one day before the operation, first 30 minutes of ICU entrance, after 24 hours, and 48 hours after operation. Normal values of reference intervals were calculated for each measurement by two different statistical methods.ResultsThere were 102 men and 38 women with age average of 61 years. There was no significant difference between genders’ WBC counts before operation (P = 0.151), ICU entrance (P = 0.391), 24 hours after surgery (P = 0.698), and 48 hours after surgery (P = 0.523). The mean values of WBC after surgery were higher than the normal range of reference interval and had an increasing trend in the first 48 hours after surgery. The WBC values were significantly different between pre and post operation (before operation and ICU admission (P = 0.001), ICU admission and 24 hours later (P = 0.001), 24 hours after surgery, and 48 hours after surgery (P = 0.001)). All post - operative reference values were significantly higher than the range for the general population.ConclusionsThere is a significant increase in WBC count after on - pump CABG. The normal range of WBC should be revised and adjusted to prevent misinterpretation as a sign of infection.

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Leukocyte activation and phagocytotic activity in cardiac surgery and infection

Cited by 19 publications

References 20 publications

Innate immunity and inflammation — New frontiers in comparative cardiovascular pathology

Innate immunity and inflammation — New frontiers in comparative cardiovascular pathology

Coronary Artery Bypass Grafting Ameliorates the Decreased Plasma Adiponectin Level in Atherosclerotic Patients

Normal Reference Interval of WBC Count After On - Pump Coronary Artery Bypass Graft; When Values Could Be Misleading

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