title: Delta chemokine (fractalkine)--a novel mediator of pulmonary arterial hypertension in children undergoing cardiac surgery.
abstract: BACKGROUND
  Fractalkine (FKN), a unique chemokine associated with pulmonary hypertension, may be involved in the acute stress response that regulates inflammation after cardiopulmonary bypass (CPB) surgery. We characterized FKN levels and correlated them with clinical parameters in children undergoing cardiac surgery involving CPB.
  
  
  METHODS
  Twenty-seven consecutive patients, aged 30 days to 11.5 years, who underwent surgery for correction of congenital heart defects, were prospectively studied. Serial blood samples were collected preoperatively, upon termination of CPB, and at six points postoperatively. Plasma was recovered immediately, aliquoted, and frozen at -70° C until assayed. Clinical and laboratory data were collected.
  
  
  RESULTS
  Baseline FKN levels were skewed between patients. Patients with low FKN levels showed significantly higher levels of oxygen saturation in room air compared to patients with high FKN levels (p<0.05). Moreover, there was a positive correlation between preoperative pulmonary arterial hypertension and FKN levels (p<0.05). Surprisingly, FKN elevation from preoperative to postoperative levels displayed no discernible pattern.
  
  
  CONCLUSIONS
  FKN levels significantly correlate with preoperative hypoxemia and PAH, suggesting that FKN may be up-regulated during hypoxemia. CPB is not associated with acute changes in circulating FKN levels. The role of FKN in the postoperative course should be further investigated.
authors.affiliation: Department of Pediatric Critical Care, The Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel. tomeriko@hotmail.com
authors.forename: Tomer
authors.initials: T
authors.lastname: Avni
authors.forename: Gideon
authors.initials: G
authors.lastname: Paret
authors.forename: Avner
authors.initials: A
authors.lastname: Thaler
authors.forename: David
authors.initials: D
authors.lastname: Mishali
authors.forename: Salem
authors.initials: S
authors.lastname: Yishay
authors.forename: Guy
authors.initials: G
authors.lastname: Tal
authors.forename: Ilan
authors.initials: I
authors.lastname: Dalal
mesh_terms: D054428:Chemokine CX3CL1 / Q000097:blood / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D007223:Infant; D008297:Male; D019616:Thoracic Surgical Procedures; D015854:Up-Regulation
chemical_list: D054428:Chemokine CX3CL1