Immune consequences of pediatric and adult cardiovascular surgery: report of the 7th Leipzig workshop.
Cardiovascular surgery in children and adults is among the most common types of interventions in the western hemisphere for innate and acquired defects. In the recent decades, the risk of cardiovascular surgery has been reduced substantially. Nevertheless, open heart surgery is risky for the patient and can lead to postoperative complications such as postpericardiotomy syndrome, capillary leak syndrome, or multiple organ failure. To gain further understanding into the response to cardiovascular surgery, it is necessary to join forces from several disciplines of medicine and natural sciences. Interdisciplinarity is the basic concept of the Leipzig Workshop. The consensus of the workshop was that cardiovascular surgery with cardiopulmonary bypass induces a systemic antiinflammatory response due to (a) elimination of activated cells, (b) compensatory reaction to a local proinflammatory responses, (c) interleukin-10 release, (d) anesthetics and medication, and (e) leukocyte extravasation. The subsequent proinflammatory reaction is the response to surgical trauma modulating the antiinflammatory reaction. Novel therapeutic approaches include the introduction of autologous endothelial progenitor cells from the peripheral blood into the sites of injury. The analysis of immune response and outcome prediction require novel analytical tools that allow fast, accurate, and quantitative determination of the desired parameters in a multiplexed manner (i.e., cytomics), such as flow cytometric microbead array assays and slide-based cytometry. The major goal is predictive medicine by cytomics, i.e., the individualized risk assessment by analyzing the cytome in combination with sophisticated data pattern recognition. These developments may lead to individualized therapy for the benefit of the patient and cost reduction.
Tárnok
Attila
A
Pediatric Cardiology, Cardiac Center Leipzig, University of Leipzig, Germany. tarnok@medizin.uni-leipzig.de
Emmrich
Frank
F
D000328:Adult; D019559:Capillary Leak Syndrome / Q000209:etiology / Q000517:prevention & control; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D002648:Child; D016207:Cytokines / Q000032:analysis / Q000276:immunology; D006801:Humans; D019044:Image Cytometry / Q000379:methods; D007118:Immunoassay / Q000379:methods; D007231:Infant, Newborn; D007249:Inflammation / Q000209:etiology* / Q000517:prevention & control; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control; D011185:Postpericardiotomy Syndrome / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors
D016207:Cytokines