Methylprednisolone prevents inflammatory reaction occurring during cardiopulmonary bypass: effects on TNF-alpha, IL-6, IL-8, IL-10.
OBJECTIVE
This study examined the correlation between tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-6 and IL-8, IL-10 and methylprednisolone pretreatment.


METHODS
This is a prospective, randomized and double-blinded study. Sixty patients undergoing coronary artery bypass grafting (CABG) were randomized to receive either intravenous methylprednisolone (n = 30, Group M) or intravenous placebo (n = 30, Group S). The patients received intravenously either 30 mg/kg methylprednisolone (Group M) or placebo (Group S) 10 min before and after cardiopulmonary bypass (CPB). In an intensive care unit (ICU), four additional doses were given at 6-hourly intervals. Blood samples for the measurements of TNF-alpha, IL-6, IL-8 and IL-10 were obtained before induction of anaesthesia (T0 = control value), after induction (T1), before starting CPB (T2), after aortic declamping (T3), at the end of CPB (T4) and 6 hours (T5), 12 hours (T6) and 24 hours (T7) after skin closure. Creatine kinase (CK) and creatine kinase isoenzyme MB (CK-MB) were evaluated at the following intervals: T0, T5, T6 and T7.


RESULTS
When compared with the control value, TNF-alpha, IL-6 and IL-8 significantly increased in Group S and Group M (p < 0.05), but these values were significantly greater in Group S than in Group M (p < 0.05). In comparison with the control value, IL-10 increased in both groups (p < 0.05), but was significantly greater in Group M than in Group S (p < 0.05). CK and CK-MB were increased in both groups in postoperative values compared to control values. In Group S, CK and CK-MB levels were significantly lower than in Group M (p < 0.05).


CONCLUSIONS
In this study, we have found that preoperative administration of methylprednisolone has decreased TNF-alpha, IL-6 and IL-8 release, and increased the perfusing IL-10 levels after CPB. Thus, methylprednisolone may decrease the inflammatory response during the CPB procedure.
Department of Cardiovascular Surgery, Meram Medical School of Selcuk University, Meram, Konya, Turkey. jalecelik@hotmail.com
Jale Bengi
JB
Celik
Niyazi
N
Gormus
Selmin
S
Okesli
Zulfikare Işik
ZI
Gormus
Hasan
H
Solak
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D008775:Methylprednisolone