Tumor necrosis factor-α production in whole blood after cardiopulmonary bypass: Downregulation caused by circulating cytokine-inhibitory activities

Börgermann, Jochen; Friedrich, Ivar; Flohé, Sascha; Spillner, Jan; Majetschak, Matthias; Kuß, Oliver; Sablotzki, Armin; Feldt, Torsten; Reidemeister, J. Chr.; Schade, F. Ulrich

doi:10.1067/mtc.2002.122300

Cited by 36 publications

(44 citation statements)

References 33 publications

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“…In accidental injury, the musculoskeletal system is most frequently involved, and post-traumatic infl ammatory reactions can better be understood by analysing the physiological responses to a standardised musculoskeletal injury. Ex vivo cytokine production of blood cultures represents an approach to evaluate the immune status [9,13] . No studies have investigated the cytokine synthesis in blood of patients undergoing major orthopaedic surgery.…”

mentioning

confidence: 99%

Reduced Capacity of Whole Blood Leucocytes to Express Tumour Necrosis Factor-α and Interleukin-10 following Major Orthopaedic Surgery

Reikeraas¹,

Sun²,

Krohn³

et al. 2005

Eur Surg Res

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Background: Severe trauma is a challenge to the immune response and may cause reduced immune capacity. As a marker of decreased cellular activity, studies with ex vivo lipopolysaccharide (LPS) stimulation of whole blood or isolated mononuclear cells from injured patients have revealed reduced production of inflammatory cytokines. To gain further insight into immune alterations in orthopaedic surgery, we studied LPS-induced tumour necrosis factor (TNF)-α and interleukin (IL)-10 in whole blood of patients during peri- and postoperative phases of total hip replacement. Methods: Four females and 3 males undergoing elective total hip replacement were included in the study. Ex vivo LPS-induced TNF-α and IL-10 were measured in a whole blood assay before, during and at 1 and 6 days after operation. In addition, the counts of white blood cells were determined. Results: During the operation, there were significant reductions in the number of monocytes, but at day 1 and 6 after surgery, there were significant increases as compared to the levels before surgery. The capacity of whole blood to express TNF-α and IL-10 did not change significantly during the operation and the following postoperative day. At day 6, however, there were significant reductions in expression of both TNF-α and IL-10 as compared to the levels before the operation. In relation to the values of monocytes, there was a significant reduction in the expression of TNF-α also at day 1 after operation. Conclusion: Our data indicate that in the course of at least 6 days after a major orthopaedic trauma, there is suppression of the whole blood capacity to express the inflammatory cytokine TNF-α and the anti-inflammatory cytokine IL-10 when exposed to LPS. During this time, then, the patient is particular susceptible to septic complications.

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confidence: 99%

Reduced Capacity of Whole Blood Leucocytes to Express Tumour Necrosis Factor-α and Interleukin-10 following Major Orthopaedic Surgery

Reikeraas¹,

Sun²,

Krohn³

et al. 2005

Eur Surg Res

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“…Release of pro-inflammatory mediators such as Regulation of cytokine synthesis in cardiac surgery: Role of extracorporeal circuit and humoral mediators in vivo and in vitro tumor necrosis factor-a (TNF-a), interleukin (IL)-6 and IL-8 [2,3] is counterbalanced by anti-inflammatory cytokines like IL-10 and transforming growth factor-ß (TGF-b) [4,5] or soluble receptors acting as antagonists [6]. This results in immune system deterioration and eventually to increased susceptibility to infections [7].…”

Section: Introductionmentioning

confidence: 99%

“…Downregulation of TNF-a-synthesis after CPB is at least in part induced by circulating cytokine-inhibitory activities. Anti-inflammatory cytokines are not responsible for the observed downregulation [5]. In addition to anesthesia and surgical trauma, the following factors might cause immunosuppression after CPB: ischemia and reperfusion, gastrointestinal endotoxin translocation, blood contact with foreign surfaces, shear stress in the extracorporeal circuit.…”

Section: Introductionmentioning

confidence: 99%

Regulation of cytokine synthesis in cardiac surgery: Role of extracorporeal circuit and humoral mediators in vivo and in vitro

et al. 2007

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“…Anaesthesia and surgery cause immune system impairment expressed as excessive pro-inflammatory responses leading to exacerbated pain, poor wound healing, psychological stress coupled with complications such as sepsis or acute respiratory distress syndrome (ARDS) [1][2][3][4] . Post-operative pain management remains a challenge even in advanced health systems like the USA, where 50-70% patients experience post-operative pain 5 .…”

Section: Introductionmentioning

confidence: 99%

Effect of low-dose ketamine on post-operative serum IL-6 production among elective surgical patients: a randomized clinical trial

Luggya¹,

Roche²,

Ssemogerere³

et al. 2017

Afr H. Sci.

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Background: Surgery and Anesthesia cause an excessive pro-inflammatory response. Mulago Hospital is faced with staff shortage making post-operative pain management difficult.Interleukin-6 (IL-6) drives inflammatory pain, endothelial cell dysfunction and fibrogenesis. Ketamine is cheap and, readily available. We hypothesized that its attenuation of serum IL-6 was a surrogate for clinical benefit. Materials and methods: Institutional Review Board's approval was sought and RCT was registered at clinical trials.gov (identifier number: NCT01339065). Consenting patients were randomized to receive pre-incision intravenous ketamine -0.5mg/kg or 0.9% saline placebo in weighted dosing. Blood samples were collected and laboratory analyzed at baseline, post-operatively in PACU, 24 and 48 hours respectively. Results: We recruited 39 patients of whom 18 were randomized to the ketamine arm and 21 in the placebo arm with follow up at 24 and 48 hours. Serum IL-6 and IL-1β levels were analyzed using ELIZA assay of pre-coated micro wells. Ketamine suppressed serum IL-6 at PACU with reduced increase at 24 hours. There was no reaction in 98% of IL-1β assayed. Conclusion: Low-dose ketamine attenuated early serum IL-6 levels due to surgical response with reduced 24 hour increase, but the difference was not statistically significant and we recommend more studies. Sci. 2017;17(2): 500-507. https://dx.doi. org/10.4314/ahs.v17i2.25

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Tumor necrosis factor-α production in whole blood after cardiopulmonary bypass: Downregulation caused by circulating cytokine-inhibitory activities

Cited by 36 publications

References 33 publications

Reduced Capacity of Whole Blood Leucocytes to Express Tumour Necrosis Factor-α and Interleukin-10 following Major Orthopaedic Surgery

Reduced Capacity of Whole Blood Leucocytes to Express Tumour Necrosis Factor-α and Interleukin-10 following Major Orthopaedic Surgery

Regulation of cytokine synthesis in cardiac surgery: Role of extracorporeal circuit and humoral mediators in vivo and in vitro

Effect of low-dose ketamine on post-operative serum IL-6 production among elective surgical patients: a randomized clinical trial

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