[en] OBJECTIVES: The goal of this study was to test the hypothesis that moderate hypothermia during cardiopulmonary bypass (CPB) provides myocardial protection by enhancing intra-myocardial anti-inflammatory cytokine balance. BACKGROUND: Moderate hypothermia during experimental CPB stimulates production of interleukin-10 (IL10) and blunts release of tumor necrosis factor-alpha (TNFalpha). METHODS: Twelve young pigs were assigned to a temperature (T degrees ) regimen during CPB: moderate hypothermia (T degrees : 28 degrees C; n = 6) and normothermia (T degrees : 37 degrees C; n = 6). Intra-myocardial TNFalpha- and IL10-messenger RNA were detected by competitive reverse transcriptase polymerase chain reaction and quantification of cytokine synthesis by Western blot. Levels of cardiac troponin I (cTnI) in cardiac lymph and in arterial and coronary venous blood were examined during and after CPB. Myocardial cell damage was assessed by histologic and ultrastructural anomalies of tissue probes taken 6 h after CPB. RESULTS: Synthesis of IL10 was significantly higher, while that of TNFalpha was significantly lower, in pigs that were in moderate hypothermia during surgery than in the others. In contrast with normothermia, moderate hypothermia was also associated with significantly lower cumulative cardiac lymphatic flow during and after CPB, significantly lower lymphatic cTnI concentrations after CPB, significantly lower percentages of myocardial cell necrosis and a significantly lower score of ultrastructural anomalies of myocardial cells. While the percentage of apoptotic cells was not different between groups, the apoptosis/necrosis ratio tended to be higher in animals that were in moderate hypothermia during surgery. In all animals, TNFalpha synthesis correlated positively while IL10 production correlated negatively with necrosis and total cell death, respectively. CONCLUSIONS: Our results suggest that moderate hypothermia during CPB provides myocardial protection by enhancing intra-myocardial anti-inflammatory cytokine balance.
Disciplines :
Pediatrics Surgery
Author, co-author :
Vazquez-Jimenez, J. F.; Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Thoracic and Cardiovascular Surgery
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Bibliography
Dreyer W.J., Phillips S.C., Lindsey M.L. (2000) Interleukin 6 induction in the canine myocardium after cardiopulmonary bypass. J Thorac Cardiovasc Surg 120:256-263.
Qing M., Vazquez-Jimenez J.F., Klosterhalfen B. (2001) Influence of temperature during cardiopulmonary bypass on leukocyte activation, cytokine balance and postoperative organ damage. Shock 15:372-377.
Tabardel Y., Duchateau J., Schmartz D. (1996) Corticosteroids increase blood interleukin-10 levels during cardiopulmonary bypass in men. Surgery 119:76-80.
Meldrum D.R. (1998) Tumor necrosis factor in the heart. Am J Physiol 274.
Torre-Amione G., Kapadia S., Benedict C. (1996) Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction: A report from the Studies of Left Ventricular Dysfunction (SOLVD). J Am Coll Cardiol 27:1201-1206.
Hennein H.A., Ebba H., Rodriguez J.L. (1994) Relationship of the proinflammatory cytokines to myocardial ischemia and dysfunction after uncomplicated coronary revascularization. J Thorac Cardiovasc Surg 108:626-635.
Weiler J.M. (1993) Introduction. Complement in Health and Disease , Whaley K, Loos M, Weiler J, editors. Dordrecht, Boston, London: Kluwer Academic Publishers; 31-37.
Meldrum D.R., Meng X., Dinarello C.A. (1998) Human myocardial tissue TNF-alpha expression following acute global ischemia in vivo. J Mol Cell Cardiol 30:1683-1689.
Frangogiannis N.G., Mendoza L.H., Lindsey M.L. (2000) IL-10 is induced in the reperfused myocardium and may modulate the reaction to injury. J Immunol 165:2798-2808.
Vazquez-Jimenez J.F., Seghaye M., Qing M. (2000) Cannulation of the cardiac lymphatic system in swine. Eur J Cardiothorac Surg 18:228-232.
Gujral J.S., Bucci T.J., Farhood A. (2001) Mechanism of cell death during warm hepatic ischemia-reperfusion in rats: Apoptosis or necrosis?. Hepatology 33:397-405.
Kalfin R.E., Engelman R.M., Rousou J.A. (1993) Induction of interleukin-8 expression during cardiopulmonary bypass. Circulation 88.
Kelly R.A., Smith T.W. (1997) Cytokines and cardiac contractile function. Circulation 95:778-781.
Laster S.M., Wood J.G., Gooding L.R. (1988) Tumor necrosis factor can induce both apoptic and necrotic forms of cell lysis. J Immunol 141:2629-2634.
Sobel B.E., LeWinter M.M. (2000) Ingenuous interpretation of elevated blood levels of macromolecular markers of myocardial injury: A recipe for confusion. J Am Coll Cardiol 35:1355-1358.
De Waal M., Abrams J., Bennett B. (1991) Interleukin 10 (IL-10) inhibits cytokine synthesis by human monocytes: An autoregulatory role of IL-10 produced by monocytes. J Exp Med 174:1209-1220.
Seghaye M., Duchateau J., Bruniaux J. (1996) Interleukin-10 release related to cardiopulmonary bypass in infants undergoing cardiac operations. J Thorac Cardiovasc Surg 111:545-553.
Schottelius A.J., Mayo M.W., Sartor R.B. (1999) Interleukin-10 signaling blocks inhibitor of kappaB kinase activity and nuclear factor kappaB DNA binding. J Biol Chem 274:31868-31874.
Yang Z., Zingarelli B., Szabo C. (2000) Crucial role of endogenous interleukin-10 production in myocardial ischemia/reperfusion injury. Circulation 101:1019-1026.
Benkhart E.M., Siedlar M., Wedel A. (2000) Role of Stat3 in lipopolysaccharide-induced IL-10 gene expression. J Immunol 165:1612-1617.
Thompson C.B. (1995) Apoptosis in the pathogenesis and treatment of disease. Science 267:1456-1462.
Matijasevic Z., Snyder J.E., Ludlum D.B. (1998) Hypothermia causes a reversible, p53-mediated cell cycle arrest in cultured fibroblasts. Oncol Res 10:605-610.
Schmidt M., Lugering N., Pauels H.G. (2000) IL-10 induces apoptosis in human monocytes involving the CD95 receptor/ligand pathway. Eur J Immunol 30:1769-1777.
Cox G. (1996) IL-10 enhances resolution of pulmonary inflammation in vivo by promoting apoptosis of neutrophils. Am J Physiol 271.
Keel M., Ungethum U., Steckholzer U. (1997) Interleukin-10 counter-regulates proinflammatory cytokine-induced inhibition of neutrophil apoptosis during severe sepsis. Blood 90:3356-3363.
McDonough J.L., Arrell D.K., Van Eyk J.E. (1999) Troponin I degradation and covalent complex formation accompanies myocardial ischemia/reperfusion injury. Circ Res 84:9-20.
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