Complement activation and release of tumour necrosis factor alpha, interleukin-2, interleukin-6 and soluble tumour necrosis factor and interleukin-2 receptors during and after cardiopulmonary bypass in children.
C3 activation products, terminal complement complex (TCC), and cytokines including interleukins 6 and 2 (IL-6, IL-2) and tumour necrosis factor-alpha (TNF), and the soluble IL-2 and TNF receptors were determined serially during and up to 48 h after open heart surgery in children. Significant increases were noted in soluble TNF and IL-2 receptor levels postoperatively (p < 0.05). No significant increase over preoperative levels was seen in the cytokines, except for IL-6 which was significantly increased postoperatively (p < 0.01), reaching a maximum 2 h postoperatively. C3 activation products and TCC levels increased significantly after weaning from cardiopulmonary bypass (p < 0.05). The IL-6 response lagged behind the complement activation. We found a significant correlation between duration of cardiopulmonary bypass and IL-6 levels 48 h postoperatively (r = 0.852, p < 0.05). We conclude that the concentration of complement activation products, IL-6 and the soluble TNF and IL-2 receptors are significantly increased after open heart surgery in children. The cytokine receptor response probably reflects some sort of regulatory mechanism.
Saatvedt
K
K
Department of Cardiovascular Surgery, Rikshospitalet, University of Oslo, Norway.
Lindberg
H
H
Geiran
O R
OR
Michelsen
S
S
Aasen
A O
AO
Pedersen
T
T
Mollnes
T E
TE
D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D003167:Complement Activation; D003176:Complement C3 / Q000378:metabolism; D015938:Complement Membrane Attack Complex / Q000378:metabolism; D004731:Endotoxins / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D007376:Interleukin-2 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D015375:Receptors, Interleukin-2 / Q000378:metabolism*; D018124:Receptors, Tumor Necrosis Factor / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D003176:Complement C3; D015938:Complement Membrane Attack Complex; D004731:Endotoxins; D007376:Interleukin-2; D015850:Interleukin-6; D015375:Receptors, Interleukin-2; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha