Pro- and anti-inflammatory cytokine patterns during and after cardiac surgery in young children

Duval, Elisabeth L.I.M.; Kavelaars, Annemieke; Veenhuizen, L.; Vught, A. J. van; Wal, H. J. C. M. Van De; Heijnen, Cobi J.

doi:10.1007/s004310051098

Cited by 43 publications

(29 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We observed expected changes in the pro and anti-inflammatory response after CPB 34 . We did not identify expected changes in claudin 3 concentrations in response to TNF-α and IFN-γ in our pilot population.…”

Section: Resultsmentioning

confidence: 62%

“…It is possible that early loss of claudin 3 expression was prevented by a protective effect of post-CPB anti-inflammatory responses. Pro and anti-inflammatory cytokines may have opposing effects on the intestinal epithelial barrier and the balance of the response determines maintenance or loss of function 34,35 . For example, IL-6 in murine models promotes intestinal epithelial proliferation and healing and could be protective if elevated in the setting of ischemia-reperfusion injury, while IFN-γ is cytotoxic 6,35 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Characteristics Associated With Postoperative Intestinal Epithelial Barrier Dysfunction in Children With Congenital Heart Disease*

Typpo

Larmonier

Deschenes

et al. 2015

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

Objective Children with congenital heart disease (CHD) have loss of intestinal epithelial barrier function (EBF), which increases their risk for post-operative sepsis and organ dysfunction. We do not understand how post-operative cardiopulmonary support or the inflammatory response to cardiopulmonary bypass (CPB) might alter intestinal EBF. We examined variation in a panel of plasma biomarkers to reflect intestinal EBF (cellular and paracellular structure and function) after CPB and in response to routine ICU care. Design Prospective cohort Setting University medical center cardiac intensive care unit Patients Twenty children aged newborn to 18 years undergoing repair or palliation of CHD with CPB. Interventions We measured baseline and repeated plasma FABP2, citrulline, claudin 3, and dual sugar permeability test (DSPT) to reflect intestinal epithelial integrity, epithelial function, paracellular integrity, and paracellular function, respectively. We measured baseline and repeated plasma pro-inflammatory (IL-6, TNF-α, IFN-γ) and anti-inflammatory (IL4, IL10) cytokines, known to modulate intestinal EBF in murine models of CPB. Measurements and Main Results All patients had abnormal baseline FABP2 concentrations (mean 3815.5 pg/mL), (normal 41–336 pg/mL). Cytokine response to CPB was associated with early, but not late changes in plasma concentrations of FABP2 and citrulline. Variation in biomarker concentrations over time were associated with aspects of ICU care indicating greater severity of illness: claudin 3, FABP2, and DSPT ratio were associated with symptoms of feeding intolerance (p<0.05) while FABP2 was positively associated with vasoactive-inotrope score (VIS) (p=0.04). Citrulline was associated with larger arteriovenous O2 saturation difference (p=0.04) and had a complex relationship with VIS. Conclusions Children undergoing CPB for repair or palliation of CHD are at risk for intestinal injury and often present with evidence for loss of intestinal epithelial integrity pre-operatively. Greater severity of illness requiring increased cardiopulmonary support rather than the inflammatory response to CPB seems to mediate late post-operative intestinal EBF.

show abstract

Section: Resultsmentioning

confidence: 62%

Section: Resultsmentioning

confidence: 99%

Clinical Characteristics Associated With Postoperative Intestinal Epithelial Barrier Dysfunction in Children With Congenital Heart Disease*

Typpo

Larmonier

Deschenes

et al. 2015

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…The post-operative cytokine response in paediatric patients is different from that in adults [6]. Recent animal studies in piglets showed that CPB without cardiac surgery elicits a proas well as an anti-inflammatory cytokine response during the first 4 h after the procedure [2].…”

Section: Discussionmentioning

confidence: 98%

Changes in lymphocyte subsets after cardiac surgery in children

Habermehl

Knuf

Kampmann

et al. 2003

European Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

“…The induction of an inflammatory response with the release of cytokines, induction of leukocyte-endothelium interaction and generation of oxygen free radicals might be the major pathomechanism for the development of the microvascular perfusion injury. In clinical as well as in experimental studies, the relationship between CPB and the production of cytokines has been demonstrated [17,20]. The contact of blood and blood cells with foreign surfaces like bypass circuits and the mechanical stress induced by the pump mechanism (especially roller pumps) are major pre-requisites for the induction of cytokine release.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Circulation and Intestinal Microcirculation: Pathophysiology and Therapeutical Options

Sack

Hagl

2002

Eur Surg Res

View full text Add to dashboard Cite

Pro- and anti-inflammatory cytokine patterns during and after cardiac surgery in young children

Abstract: The downregulation of ex vivo pro- and, to some extent, anti-inflammatory cytokine production may be a reflection of a cellular stress response, induced by anaesthesia, cardiopulmonary bypass and surgery.

Cited by 43 publications

References 25 publications

Clinical Characteristics Associated With Postoperative Intestinal Epithelial Barrier Dysfunction in Children With Congenital Heart Disease*

Clinical Characteristics Associated With Postoperative Intestinal Epithelial Barrier Dysfunction in Children With Congenital Heart Disease*

Changes in lymphocyte subsets after cardiac surgery in children

Extracorporeal Circulation and Intestinal Microcirculation: Pathophysiology and Therapeutical Options

Contact Info

Product

Resources

About