Hepatic release of interleukin-10 during cardiopulmonary bypass in steroid-pretreated patients.
With its antiinflammatory properties, interleukin (IL)-10 may play an important role in limiting complications associated with cardiopulmonary bypass (CPB). We previously demonstrated that pretreatment with steroids can significantly increase IL-10 production during CPB, but neither the heart nor the lung was found to be its main source. To define whether the liver is the source of IL-10, hepatic venous cannulation was performed in 12 patients undergoing CPB. Each patient received 30 mg/kg of methylprednisolone before operation. Plasma levels of IL-10 were simultaneously measured in peripheral arterial blood and hepatic venous blood before heparin administration, before aortic cross-clamping, and 5, 30, 60, 90, and 120 minutes after aortic declamping. The duration of CPB and aortic cross-clamping was 113 +/- 7 minutes and 75 +/- 6 minutes (mean +/- SEM), respectively. IL-10 levels 30 minutes after declamping were significantly higher in hepatic venous blood than in arterial blood (1187 +/- 573 pg/ml vs 911 +/- 405 pg/ml, p < 0.01 by Wilcoxon's signed-rank test). To determine whether steroids can also induce the release of another antiinflammatory cytokine, IL-4, plasma IL-4 levels were measured simultaneously. IL-4 was detected in the arterial blood of only 4 of the 12 patients, transiently after aortic declamping. IL-4 was not detected in hepatic venous blood. In conclusion, the liver is a major source of IL-10 during CPB. However, steroid-treated patients do not show an increase in IL-4, and the liver is not the source of IL-4 during and after CPB.
Wan
S
S
Department of Cardiac Surgery, University Hospital Erasme, Free University of Brussels, Belgium.
LeClerc
J L
JL
Schmartz
D
D
Barvais
L
L
Huynh
C H
CH
Devière
J
J
DeSmet
J M
JM
Vincent
J L
JL
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D016753:Interleukin-10 / Q000097:blood / Q000378:metabolism*; D015847:Interleukin-4 / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology*; D008875:Middle Aged; D011446:Prospective Studies
D000893:Anti-Inflammatory Agents; D016753:Interleukin-10; D015847:Interleukin-4; D008775:Methylprednisolone