Surgical trauma affects the proinflammatory status after cardiac surgery to a higher degree than cardiopulmonary bypass

Prondzinsky, Roland; Knüpfer, A; Loppnow, Harald; Redling, F; Lehmann, Dirk J.; I, Stabenow; Witthaut, R; Unverzagt, Susanne; Radke, J.; Zerkowski, Hans‐Reinhard; Werdan, Karl

doi:10.1016/j.jtcvs.2004.07.052

Cited by 85 publications

(66 citation statements)

References 27 publications

(23 reference statements)

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“…Furthermore, the concentrations reached interstitially in vivo are likely to be much higher. Pathophysiologically, IL-6 concentrations can range from approximately 640 pg/ml postoperatively in systemic inflammatory response syndrome (SIRS) following coronary artery bypass grafting [35] to 14 ng/ml in sepsis [36].…”

Section: Discussionmentioning

confidence: 99%

IL-6 induces PI 3-kinase and nitric oxide-dependent protection and preserves mitochondrial function in cardiomyocytes

Smart

Mojet

Latchman

et al. 2006

Cardiovascular Research

116

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Section: Discussionmentioning

confidence: 99%

IL-6 induces PI 3-kinase and nitric oxide-dependent protection and preserves mitochondrial function in cardiomyocytes

Smart

Mojet

Latchman

et al. 2006

Cardiovascular Research

116

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“…This originates from, e.g., leukocyte contact activation in the extracorporeal circuit, initiation of tissue plasminogen activator and complementmediated cascades (Rubens et al 2005), tissue damage associated with thoracotomy (Prondzinsky et al 2005), administration of anaesthetics and analgesics (Hambsch et al 2002), perioperative leakage of endotoxins from the gut (Jansen et al 1992) and activation of endothelial cells as a result of ischemia-reperfusion injury. The latter is associated with the enhanced release of endothelial adhesion molecules, including soluble intercellular and vascular cell adhesion molecule-1 (sICAM-1, sVCAM-1) and E-selectin (Kalawski et al 1998).…”

Section: Systemic Inflammatory Responses After On-pump Cardiac Surgerymentioning

confidence: 99%

Hsp70 and cardiac surgery: molecular chaperone and inflammatory regulator with compartmentalized effects

Jong

Schadenberg

Jansen

et al. 2009

Cell Stress and Chaperones

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Open heart surgery is a unique model to study the interplay between cellular injury, regulation of inflammatory responses and tissue repair. Stress-inducible heat shock protein 70-kDa (Hsp70) provides a molecular link between these events. In addition to molecular chaperoning, Hsp70 exerts modulatory effects on endothelial cells and leukocytes involved in inflammatory networks. Hsp70 residing in the intracellular compartment is part of an inhibitory feedback loop that acts on nuclear factor kappaB (NF-kappaB). In contrast, extracellular Hsp70 is recognized by multiple germline-encoded immune receptors, e.g., Toll-like receptor (TLR) 2, TLR4, LOX-1, CD91, CD94, CCR5 and CD40. Hsp70 is thereby able to enhance chemotaxis, phagocytosis and cytolytic activity of innate immune cells and stimulate antigen-specific responses. These apparent contradictory pro- and anti-inflammatory effects of endogenous Hsp70 in the context of cardiac surgery are still not fully understood. An all-embracing model of the compartmentalized effects of endogenous Hsp70 in the orchestration of inflammatory responses in cardiac surgery is proposed.

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“…Our results -with oxidative stress, chemokine production, and hepatic tissue EC -being highly affected after surgery, support the initial hypothesis. In a similar manner, recent studies on patients subjected to cardiosurgical operations, reported that surgical trauma alone, and not the cardiopulmonary by-pass procedure, caused the rise in chemokines and proinflammatory mediators at an early stage of the operation [5,[24][25][26]. To test the hypothesis that liver is a major source of circulating CC chemokines in various conditions, mainly via the chemokine secretion by Kupffer cells [27][28][29][30], we examined MCP-1 and RANTES mRNA expression in liver homogenates.…”

Section: Discussionmentioning

confidence: 91%

Oxidative stress due to anesthesia and surgical trauma: Importance of early enteral nutrition

Kotzampassi

Kolios²,

Manousou

et al. 2009

Molecular Nutrition Food Res

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Anesthesia and surgical trauma are considered major oxidative and nitrosative stress effectors resulting in the development of SIRS. In this study we evaluated the usefulness of early enteral nutrition after surgical trauma. Sixty male Wistar rats were subjected to midline laparotomy and feeding-gastrostomy. Twenty of these rats served as controls after recovering from the operation stress. The remaining rats received, through gastrostomy, enteral nutrition or placebo-feeding for 24 h. Oxidative stress markers and CC chemokine production were evaluated in rat serum and liver tissue. The operation itself was found to increase nitric oxide (NO) and malondialdehyde (MDA) and to decrease superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), as well as liver tissue energy charge (EC) in relation to controls. The rats receiving enteral feeding exhibited statistically significantly lower levels of NO and MDA, and higher levels of SOD, GSH-Px, and liver EC, in relation to placebo feeding rats. The operation significantly increased the chemokines monocyte chemoattractant protein (MCP)-1 and regulated upon activation, normal T-cell expressed, and secreted (RANTES) in rat serum, while enteral nutrition caused a further significant increase in chemokine levels in serum. mRNA chemokine expression in liver was increased in a similar pattern. These findings indicate that early enteral feeding might play an important role after surgery ameliorating oxidative stress, affecting positively the hepatic EC and regulating, via chemokine production, cell trafficking, and healing process.

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Surgical trauma affects the proinflammatory status after cardiac surgery to a higher degree than cardiopulmonary bypass

Abstract: These findings support the suggestion that surgical trauma and cardiopulmonary bypass contribute to the inflammatory response after cardiac surgery, although trauma may contribute to a higher degree.

Cited by 85 publications

References 27 publications

IL-6 induces PI 3-kinase and nitric oxide-dependent protection and preserves mitochondrial function in cardiomyocytes

IL-6 induces PI 3-kinase and nitric oxide-dependent protection and preserves mitochondrial function in cardiomyocytes

Hsp70 and cardiac surgery: molecular chaperone and inflammatory regulator with compartmentalized effects

Oxidative stress due to anesthesia and surgical trauma: Importance of early enteral nutrition

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