Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Wei, Minxin; Laurikka, Jari; Kuukasjärvi, Pekka; Pehkonen, Erkki; Tarkka, Matti

doi:10.1177/021849230301100303

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…As described by Allen et al (29), cell salvage and washing significantly reduce the concentration of the measured cytokines in this study. In contrary to what we expected based on the literature on CABG procedures (8,30) and sepsis (31), we did not find any upregulation of soluble adhesion molecules in plasma. At the end of surgery, we observed a drop in the levels of soluble endothelial adhesion molecules that can be explained by the effects of hemodilution.…”

Section: Discussioncontrasting

confidence: 99%

Off-Pump CABG Surgery Reduces Systemic Inflammation Compared With On-Pump Surgery but Does Not Change Systemic Endothelial Responses

Jongman

Zijlstra²,

Kok³

et al. 2014

Shock

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Coronary artery bypass graft (CABG) surgery can result in severe postoperative organ failure. During CABG surgery, cardiopulmonary bypass (CPB) with cardiac arrest is often used (on-pump CABG), which often results in a systemic inflammatory response. To reduce this inflammatory response, off-pump CABG was reintroduced, thereby avoiding CPB. There is increasing evidence that the endothelium plays an important role in the pathophysiology of organ failure after CABG surgery. In this study, 60 patients who were scheduled for elective CABG surgery were randomized to have surgery for on-pump or off-pump CABG. Blood was collected at four time points: start, end, 6 h, and 24 h postoperatively. Levels of inflammatory cytokines, soluble adhesion molecules, and angiogenic factors and their receptors were measured in the plasma. No differences were found in preoperative characteristics between the patient groups. The levels of tumor necrosis factor-α, interleukin 10, and myeloperoxidase, but not interleukin 6, were increased to a greater extent in the on-pump CABG compared with off-pump CABG after sternum closure. The soluble endothelial adhesion molecules E-selectin, vascular cell adhesion molecule 1, and intracellular adhesion molecule 1 were not elevated in the plasma during and after CABG surgery in both on-pump and off-pump CABG. Angiopoietin 2 was only increased 24 h after surgery in both on-pump and off-pump CABG. Higher levels of sFlt-1 were found after sternum closure in off-pump CABG compared with on-pump CABG. Avoiding CPB and aortic cross clamping in CABG surgery reduces the systemic inflammatory response. On-pump CABG does not lead to an increased release of soluble endothelial adhesion molecules in the circulation compared with off-pump CABG.

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Section: Discussioncontrasting

confidence: 99%

Off-Pump CABG Surgery Reduces Systemic Inflammation Compared With On-Pump Surgery but Does Not Change Systemic Endothelial Responses

Jongman

Zijlstra²,

Kok³

et al. 2014

Shock

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“…Prior studies of patients undergoing on-pump cardiac surgery have shown an association of circulating sICAM-1 levels with pulmonary dysfunction (Gorlach et al, 2003), and of sE-selectin, P-selectin and sICAM-1 levels with prolonged postoperative requirement for vasopressor use (Wei et al, 2003), and post-operative development of sepsis (Paret et al, 2000). Although we found a uniform increase in plasma sICAM-1 and sE-selectin in response to CPB, these markers did not discriminate between the AKI and control groups.…”

Section: Discussionmentioning

confidence: 99%

Exploration of disease mechanism in acute kidney injury using a multiplex bead array assay: a nested case–control pilot study

Liangos¹,

Addabbo

Tighiouart

et al. 2010

Biomarkers

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Context-Acute kidney injury (AKI) following cardiac surgery with cardiopulmonary bypass (CPB) causes increased morbidity and mortality.Objective-Evaluate the plasma profile of biomarkers potentially involved in AKI following CPB.Methods-In a nested case-control study, plasma levels of 27 biomarkers in 11 AKI cases were compared with 25 controls.Results-Pre CPB, plasma levels of epidermal growth factor and macrophage inflammatory protein-1β; 2 hours following CPB, soluble vascular cell adhesion molecule-1, fractalkine and macrophage inflammatory protein-1α; and at later time points, sVCAM-1 and interleukin-6 were associated with AKI.Conclusion-Biomarkers associated with AKI following CPB may merit further study.

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“…Wei et al found that sICAM-1 concentration in plasma was significantly higher in patients with necessity of norepinephrine infusion in the ICU after CABG surgery. Nevertheless, levels of sICAM-1 did not correlate with the duration of bypass, aortic crossclamping, or creatinine kinase-MB concentration (55). Patients with postoperative respiratory insufficiency had a significantly higher level of sICAM-1 and white blood cell count compared to patients with uneventful postoperative course after CABG (56).…”

Section: Adhesion Molecules and Organ Damagementioning

confidence: 99%

Markers of endothelial dysfunction after cardiac surgery: Soluble forms of vascular-1 and intercellular-1 adhesion molecules

et al. 2009

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Endothelium forms an inner layer of vascular wall. It plays an important role in inflammatory process, regulation of vascular tone, and synthesis of thromboregulatory substances. Leukocyte and endothelium interactions during inflammation are regulated by different families of adhesion molecules. Increased levels of soluble forms of adhesion molecules have been detected in the circulating blood in conditions such as autoimmune diseases, transplant rejection, ischemia-reperfusion injury in addition to neutrophil- and endothelial membrane-bound forms reflecting the level of endothelial dysfunction. It is known that endothelial dysfunction is a risk factor for ischemic events such as stroke, myocardial infarction, unstable angina pectoris, ventricle fibrillation, necessity of revascularisation procedures, and death from cardiovascular reasons. Clinical studies showed that cardiac surgery has an impact on vascular endothelial function as well. The amount of endotheliumderived soluble forms of vascular-1 and intercellular-1 adhesion molecules increases after cardiopulmonary bypass suggesting endothelial dysfunction. However, further investigations are needed to be done to support the evidence that endothelial dysfunction proceeding heart surgery is one of the reasons of tissue ischemia-reperfusion injury.

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Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Cited by 3 publications

References 23 publications

Off-Pump CABG Surgery Reduces Systemic Inflammation Compared With On-Pump Surgery but Does Not Change Systemic Endothelial Responses

Off-Pump CABG Surgery Reduces Systemic Inflammation Compared With On-Pump Surgery but Does Not Change Systemic Endothelial Responses

Exploration of disease mechanism in acute kidney injury using a multiplex bead array assay: a nested case–control pilot study

Markers of endothelial dysfunction after cardiac surgery: Soluble forms of vascular-1 and intercellular-1 adhesion molecules

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