Comparison of m-RNA expression for inflammatory mediators in leukocytes between on-pump and off-pump coronary artery bypass grafting.
OBJECTIVE
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response. This is mainly attributed to cytokine release caused by CPB and global myocardial ischemia. Coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG, OPCAB) is now accepted as a less invasive technique than conventional CABG. This study was designed to compare the inflammatory response at the m-RNA level of proinflammatory cytokines and adhesion molecules before and after operation in patients undergoing CABG with and without CPB.


METHODS
Twenty patients who underwent isolated CABG with CPB (on-pump group, n=10) or without CPB (off-pump group, n=10) were studied. By utilizing a semiquantitative reverse transcription polymerase chain reaction (RT-PCR) technique, gene expression of cytokines, adhesion molecules, and vasoactive substances in leukocytes of peripheral blood were evaluated before and six hours after surgery.


RESULTS
Postoperative expression of m-RNA for interleukin (IL)-1, -8, and -10, tumor necrosis factor (TNF)-alpha, heme oxygenase (HO)-1, platelet endothelial cellular adhesion molecule (PECAM) and Mac-1 increased significantly in the on-pump group but not in the off-pump group (p<0.05).


CONCLUSIONS
In view of the m-RNA level of proinflammatory cytokines and adhesion molecules, it can be concluded that OPCAB is a less invasive technique than on-pump CABG. Direct contact of circulating blood with the synthetic surfaces of the CPB system may be the main cause of the systemic inflammation.
Okubo
Naoko
N
Department of Surgery II, Nippon Medical School, Tokyo, Japan.
Hatori
Nobuo
N
Ochi
Masami
M
Tanaka
Shigeo
S
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D016207:Cytokines / Q000097:blood* / Q000235:genetics; D005260:Female; D015870:Gene Expression; D006419:Heme Oxygenase (Decyclizing) / Q000097:blood; D051547:Heme Oxygenase-1; D006801:Humans; D007249:Inflammation / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007962:Leukocytes / Q000737:chemistry*; D016177:Macrophage-1 Antigen / Q000097:blood; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000097:blood; D012333:RNA, Messenger / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D007375:Interleukin-1; D016209:Interleukin-8; D016177:Macrophage-1 Antigen; D008565:Membrane Proteins; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; C496541:HMOX1 protein, human; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1