Thorac Cardiovasc Surg 2009; 57(1): 25-29
DOI: 10.1055/s-2008-1039044
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Secretion of Soluble ST2 – Possible Explanation for Systemic Immunosuppression after Heart Surgery

T. Szerafin1 [*] , T. Niederpold2 [*] , A. Mangold2 [*] , K. Hoetzenecker2 , S. Hacker2 , G. Roth3 , M. Lichtenauer2 , M. Dworschak3 , E. Wolner2 , H. J. Ankersmit2
  • 1Department of Cardiac Surgery, University of Debrecen, Debrecen, Hungary
  • 2Department of Cardiothoracic Surgery, General Hospital Vienna, Medical University of Vienna, Vienna, Austria
  • 3Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, General Hospital Vienna, Medical University of Vienna, Vienna, Austria
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Publikationsverlauf

received April 25, 2008

Publikationsdatum:
23. Januar 2009 (online)

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Abstract

Background: Cardiopulmonary bypass is known to affect cytokine release leading to a generalized endogenous immune reaction similar to that described in sepsis, without having been explored in great detail. Therefore we evaluated the anti- and pro-inflammatory cytokine responses after heart surgery. Methods: 16 patients who underwent coronary artery bypass graft (CABG) surgery with extracorporeal circulation were included. ST2, IL-4 and IL-10 served as markers for TH2 cytokine response; IL-6, IL-8 and IFN-gamma as TH1 markers. Furthermore, total immunoglobulin subtype analysis (IgM, IgG, IgE) was performed. Results: Serum levels of soluble ST2 started to climb at 60 minutes (from 38 ± 14 preoperatively to 1 480 ± 890 pg/ml) and peaked 24 hours after surgery (13 360 ± 2 840 pg/ml, p < 0.001). IL-10 reached a maximum at 60 minutes and returned to baseline levels 24 hours later. IL-6 and IL-8 levels peaked 60 minutes after surgery. IL-4 and IFN-gamma did not change. Only IgM showed a significant peak on day eight (p < 0.001). Conclusion: Our results demonstrate that CABG surgery induces a massive long-lasting secretion of ST2, a protein related to immune suppression.

References

1 Szerafin, Niederpold and Mangold share the first authorship.

MD Hendrik Jan Ankersmit

Department of Cardiothoracic Surgery
General Hospital Vienna
Medical University of Vienna

Waehringer Guertel 18/20

1090 Vienna

Austria

Telefon: + 43 14 04 00 69 66

Fax: + 43 14 04 00 56 30

eMail: hendrik.ankersmit@meduniwien.ac.at