title: Interleukin-10 release related to cardiopulmonary bypass in infants undergoing cardiac operations.
abstract: To evaluate cytokine balance related to cardiopulmonary bypass, we prospectively investigated 11 infants undergoing cardiac operations for congenital heart disease. Proinflammatory cytokines (tumor necrosis factor-alpha and interleukin-8) and the antiinflammatory cytokine interleukin-10 were measured at multiple time points before, during, and after bypass. Tumor necrosis factor-alpha and interleukin-8 values were within normal range before the operation. These values increased significantly during bypass, reaching their peaks after protamine administration (tumor necrosis factor-alpha, 133.6 +/- 124.9 pg/ml; mean +/- standard deviation; p<0.005) and 2 hours after termination of the procedure (interleukin-8, 92.1 +/- 44.1 pg/ml; p < 0.01). Tumor necrosis factor-alpha and interleukin-8 equaled normal prebypass values from the first postoperative day on. Interleukin-10 levels were within normal range before the operation and were already significantly increased 10 minutes after initiation of bypass (interleukin 10, 39.4 +/- 34.3 pg/ml; p<0.05). These levels remained elevated throughout the procedure but returned to normal after protamine administration. A second significant release of interleukin-10 occurred from the early postoperative period on, reaching its peak 24 hours after termination of cardiopulmonary bypass (interleukin-10, 351.6 +/- 304.0 pg/ml; p < 0.01). Interleukin-10 values were normal on the second postoperative day in all patients. Interleukin-10 kinetics showed an inverse pattern compared with tumor necrosis factor-alpha and interleukin-8. This difference suggests an interplay between proinflammatory and antiinflammatory cytokines released during and after cardiopulmonary bypass. Interleukin-10 levels measured 4 and 24 hours after bypass strongly correlated with the degree of hypothermia during bypass (Spearman's correlation coefficient, -0.77 [p < 0.01] and -0.89 [p < 0.0005], respectively); these levels did not correlate with duration of bypass and aortic crossclamping, however. This result suggests that besides immunologically mediated production of interleukin-10, hypothermia itself could modulate interleukin-10 production. In conclusion, this study demonstrates interleukin-10 production, in addition to interleukin-8 and tumor necrosis factor-alpha synthesis, in response to cardiopulmonary bypass in infants. Interleukin-10 could play a protective role by down-regulating proinflammatory cytokine release during and after cardiopulmonary bypass.
authors.affiliation: Department of Pediatric Cardiac Intensive Care, Centre Chirurgical Marie-Lannelongue, Le Plessis-Robinson, France.
authors.forename: M
authors.initials: M
authors.lastname: Seghaye
authors.forename: J
authors.initials: J
authors.lastname: Duchateau
authors.forename: J
authors.initials: J
authors.lastname: Bruniaux
authors.forename: S
authors.initials: S
authors.lastname: Demontoux
authors.forename: C
authors.initials: C
authors.lastname: Bosson
authors.forename: A
authors.initials: A
authors.lastname: Serraf
authors.forename: G
authors.initials: G
authors.lastname: Lecronier
authors.forename: E
authors.initials: E
authors.lastname: Mokhfi
authors.forename: C
authors.initials: C
authors.lastname: Planche
mesh_terms: D000768:Anesthesia, General; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D016753:Interleukin-10 / Q000097:blood / Q000378:metabolism*; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10