title: Influence of methylprednisolone on levels of neuron-specific enolase in cardiac surgery: a corticosteroid derivative to decrease possible neuronal damage.
abstract: BACKGROUND
  Cerebral injury is a well-known complication after cardiac surgery with cardiopulmonary bypass (CPB), especially in adult patients. Specific biochemical markers like neuron-specific enolase (NSE) and S-100beta protein were developed previously for early detecting neuronal damage after CPB. Corticosteroids are shown to reduce multisystemic deleterious effects of cardiopulmonary bypass due to their anti-inflammatory characteristics. The aim of this study is to demonstrate the decrease of serum neuron-specific enolase levels in patients who received corticosteroids before CPB.
  
  
  METHODS
  Thirty patients scheduled for elective coronary bypass surgery were included in the study. Patients were divided randomly into two groups as the control group (n = 15) who underwent a standard coronary bypass surgery without any additional medication and the study group (n = 15) who received 1 gm of methylprednisolone before CPB. Blood samples for analysis of serum NSE, interleukin-6 (IL-6), and IL-10 were drawn before CPB, 4 and 24 hours after the end of extracorporeal circulation.
  
  
  RESULTS
  Serum cytokine and NSE levels were significantly increased after CPB above their normal range in both groups. In the study group, IL-6 and NSE levels were significantly reduced while IL-10 levels were much higher after CPB. High NSE levels significantly correlated with IL-6 levels in the control group.
  
  
  CONCLUSIONS
  The lower levels of NSE in patients who received methylprednisolone may suggest that corticosteroids might be useful in decreasing possible neuronal damage during heart surgery. However, we were not able to demonstrate an adverse neurological outcome.
authors: Department of Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Capa, Istanbul, Turkey. dr.tolgademir@gmail.com
authors: Tolga
authors: T
authors: Demir
authors: Hale
authors: H
authors: Demir
authors: Türkan
authors: T
authors: Tansel
authors: Yusuf
authors: Y
authors: Kalko
authors: Emin
authors: E
authors: Tireli
authors: Enver
authors: E
authors: Dayioglu
authors: Semih
authors: S
authors: Barlas
authors: Ertan
authors: E
authors: Onursal
mesh_terms: D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood / Q000517:prevention & control; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011292:Premedication
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D018696:Neuroprotective Agents; D016753:Interleukin-10; D010751:Phosphopyruvate Hydratase; D008775:Methylprednisolone