title: Influence of methylprednisolone on cytokine balance during cardiac surgery.
abstract: 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.
authors: Department of Anesthesiology, School of Medicine, Iwate Medical University, Japan.
authors: T
authors: T
authors: Kawamura
authors: K
authors: K
authors: Inada
authors: N
authors: N
authors: Nara
authors: R
authors: R
authors: Wakusawa
authors: S
authors: S
authors: Endo
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D007378:Interleukins; D008775:Methylprednisolone