Abstract
To evaluate the effect of cardiopulmonary bypass on immunological function, we measured interleukin-6 (IL-6) and tumor necrosis factor (TNF) in 12 patients undergoing cardiac surgery during and after cardiopulmonary bypass, and in 10 patients with pancreatoduodenectomy. Plasma IL-6 levels were determined using the Human Interleukin 6 ELISA Kit, and TNF levels were determined using a highly sensitive sandwich enzyme immunoassay. In patients with cardiac surgery, plasma levels of IL-6 and TNF increased during cardiopulmonary bypass, and in patients with pancreatoduodenectomy, IL-6 and TNF levels significantly increased at the end of intraabdominal manipulation. These results suggest that endotoxin may have activated the immune system and stimulated cytokine production after pancreatoduodenectomy and during bypass.
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Fong Y, Moldawer LL, Shires GT, Lowry SF (1990) The biologic characteristics of cytokines and their implication in surgical injury. Surg Gynecol Obstet 170:363–378
Myers MA, Fleck A, Samson B, Colley CM, Benf J, Hall G (1984) Early plasma protein and mineral changes after surgery: a two-stage process. J Clin Pathol 37:862–826
Beutler BA, Milsark IW, Cerami A (1985) Cachectin/tumor necrosis factor: production, distribution, and metabolic fate in vivo. J Immunol 135:3972–3977
Saukkonen K, Sande S, Cioffe C, Wolpe S, Sherry B, Cerami A, Tuomanen E (1990) The role of cytokines in the generation of inflammation and tissue damage in experimental gram-positive meningitis. J Exp Med 171:439–448
Hisatomi K, Isomura T, Kawara T (1989) Changes in lymphocyte subsets, mitogen responsiveness, and interleukin-2 production after cardiac operations. J Thorac Cardiovasc Surg 98:580–591
Lahat N, Zlotnick AY, Schtiller R, Bar I, Merin G (1992) Serum levels of IL-1, IL-6 and tumor necrosis factor in patients undergoing coronary artery bypass grafts of cholecystectomy. Clin Exp Immunol 89:255–260
Ida N, Sakurai S, Hosaka T, Hosoi K, Kunitomo T, Matsuura Y, Kohase M (1991) An enzyme-linked immunosorbent assay for the measurement of human interleukin-6. J Immunol Methods 133:279–284
Engelberts I, Moller A, Schoen GJM, Van der Linden C, Buurman WA (1991) Evaluation of measurement of human TNF in plasma by ELISA. Lympho Cytokines Res 10:69–76
Natanson C, Eichenholz PW, Danner RL, Eichacker PQ, Hoffman WD, Kuo GC, Banks SM, Macvittie TJ, Parrillo JE (1989) Endotoxin and tumor necrosis factor in dogs stimulate the cardiovascular profile of human septic shock. J Exp Med 169:823–832
Beutler B, Cerami A (1988) Tumor necrosis, cachexia shock and inflmmation: A common mediator. Ann Rev Biochem 57:505–518
Fong Y, Moldawer LL, Marano M, Wei H, Tatter SB, Clarick RH, Santhanam U, Sherris D, May LT, Sehgal PB, Lowry SF (1989) Endotoxemia elicits increased circulating B2-IFN/IL-6 in man. J Immunol 142:2321–2324
Naito Y, Tamai S, Shingu K, Sindo K, Matusi T, Segawa H, Nakai Y, Mori K (1992) Responses of plasma adrenocorticotropic hormone, cortisol and cytokines during and after upper abdominal surgery. Anesthesiology 77:426–431
Zuckerman SH, Shellhaas J, Butler LD (1989) Differential regulation of lipopolysaccharide-induced interleukin 1 and tumor necrosis factor synthesis: Effects of endogenous and exogenous glucocorticoids and the role of pituitary-adrenal axis. Eur J Immunol 19:301–305
Sakai T, Latson TW, Whitten CW, Ring WS, Lipton JM, Giesecke AH, O'Flaherty DN (1993) Perioperative measurements of interleukin-6 and α-melanocyte-stimulating hormone in cardiac transplant patients. J Cardiothorac Vasc Anesth 7:17–22
Hisatomi K, Isomura T, Galli SJ (1992) Augmentation of interleukin-2 production after cardiac operations in patients treated with erythropoietin. J Thorac Cardiovasc Surg 104:278–283
Ide H, Kakiuchi T, Furuta N, Matsumoto H, Sudo K, Furuse A, Asano K (1987) The effect of cardiopulmonary bypass on T cells and their subpopulations. Ann Thorac Surg 44:277–282
William FC, Gabriel JH, Raafat SH, Frank MM, Waheed NK (1992) Circulating endotoxin and tumor necrosis factor during pediatric cardiac surgery 20:1090–1096
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Nishimura, M., Abe, K., Sakakibara, T. et al. Responses of interleukin-6 and tumor necrosis factor during and after cardiac surgery undergoing cardiopulmonary bypass and pancreatoduodenectomy. J Anesth 9, 146–150 (1995). https://doi.org/10.1007/BF02479846
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DOI: https://doi.org/10.1007/BF02479846