Platelet activation and cytokine production during hypothermic cardiopulmonary bypass--a possible correlation?
Cardiopulmonary bypass (CPB) is associated with impaired platelet function and a systemic inflammatory response. The present study was designed to evaluate whether any correlation between platelet activation and inflammatory response during CPB exists. The results obtained from 8 patients undergoing hypothermic CPB for cardiac surgery showed the occurrence of a moderate degree of platelet activation during CPB, demonstrated by an increase of platelet CD62P expression in correlation with an increase of beta-thromboglobulin levels, with a concomitant decrease of in vitro platelet response. Plasma IL-1beta levels significantly increased during CPB, with a peak between 1 and 4 h after CPB. Similarly, IL-6 levels were elevated 30 min from CPB starting, peaked at 4 h, and remained elevated after 24 h. A direct correlation was found between plasma IL-1beta and IL-6 levels. A significant correlation between plasma IL-1beta and beta-thromboglobulin levels was also found. In turn, plasma beta-thromboglobulin levels correlated with CD62P expression on activated platelets. An inverse correlation was found between in vitro platelet aggregation and plasma IL-1beta or IL-6 levels. From the present results it may be speculated that platelet activation during CPB may contribute, through the release of IL-1beta, to activation of endothelial cells and subsequent release of other cytokines with chemotactic and pro-inflammatory properties, thus playing an important role in the inflammatory response associated with CPB.
Department of Experimental Medicine and Pathology, University of Rome La Sapienza, Italy.
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Ferroni
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Speziale
G
G
Ruvolo
A
A
Giovannelli
F M
FM
Pulcinelli
L
L
Lenti
P
P
Pignatelli
A
A
Criniti
E
E
Tonelli
B
B
Marino
P P
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Gazzaniga
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007249:Inflammation / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation; D011108:Polymers; D013499:Surface Properties
D016207:Cytokines; D011108:Polymers