Influence of methylprednisolone on cytokine balance during cardiac surgery.
OBJECTIVE
To determine the influence of methylprednisolone on the cytokine balance during cardiac surgery.


METHODS
Prospective, randomized, nonblinded study.


METHODS
University hospital.


METHODS
Twenty-one patients on cardiopulmonary bypass undergoing aortocoronary bypass surgery.


METHODS
According to a randomized sequence, the patients either received methylprednisolone (30 mg/kg) [corrected] before cardiopulmonary bypass and before declamping of the aorta (MPS group, n = 11) or received nothing (control group, n = 10).


RESULTS
Serum proinflammatory cytokines (interleukin [IL]-8, IL-6) and anti-inflammatory cytokines (IL-10, IL-1ra) were measured by enzyme-linked immunosorbent assays. Serum IL-6 and IL-8 concentrations in the control group (15.2 +/- 4.1 and 14.1 +/- 1.9 pg/mL, preoperatively) increased to 242 +/- 70.1 and 97.3 +/- 18.3 pg/mL at 60 mins after declamping of the aorta (p < .01, p < .01, respectively). The increases were greater than those from 2.5 +/- 0.6 and 2.5 +/- 0.5 pg/mL to 109.5 +/- 29.0 and 33 +/- 4.1 pg/mL in the MPS group for IL-6 and IL-8, respectively. Serum IL-10 concentrations increased significantly 60 mins after declamping of the aorta compared with its preoperative value in the two groups (the control group, from 1.0 +/- 0 to 537.9 +/- 61.7 pg/mL; the MPS group, from 0.3 +/- 0.2 to 654.9 +/- 24 pg/mL [p < .01, p < .01, respectively]). No difference was found between the two groups. Similarly, serum IL-1ra concentrations in the two groups increased the preoperative value in the control group from 304 +/- 120 to 44,374 +/- 14,631 pg/mL and in the MPS group from 616.5 +/- 109.6 to 35,598 +/- 9,074 pg/mL at 60 mins after declamping of the aorta (p < .01, p < .01, respectively). There was no difference between the two groups.


CONCLUSIONS
Methylprednisolone reduces the production of IL-6 and IL-8 but not that of IL-10 and IL-1ra. These results suggest that one of the mechanisms of the cytoprotective effect of methylprednisolone may be to make changes in the proinflammatory and anti-inflammatory cytokine balance.
Kawamura
T
T
Department of Anesthesiology, School of Medicine, Iwate Medical University, Japan.
Inada
K
K
Nara
N
N
Wakusawa
R
R
Endo
S
S
D000368:Aged; D000704:Analysis of Variance; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004797:Enzyme-Linked Immunosorbent Assay; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006439:Hemodynamics; D006801:Humans; D007378:Interleukins / Q000097:blood*; D008775:Methylprednisolone / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology
D005938:Glucocorticoids; D007378:Interleukins; D008775:Methylprednisolone