title: Activation of the receptor activator of the nuclear factor-κB ligand pathway during coronary bypass surgery: comparison between on- and off-pump coronary artery bypass surgery procedures.
abstract: OBJECTIVE
  The receptor activator of the nuclear factor kappa-B (NF-κB) ligand (RANKL), its membrane receptor RANK and its decoy receptor osteoprotegerin (OPG) are all members of the tumour necrosis factor family involved in bone metabolism and immune response. We evaluated the activation of the OPG/RANKL/RANK pathway in patients undergoing cardiac surgery with and without cardiopulmonary bypass (CPB).
  
  
  METHODS
  Twenty consecutive patients undergoing elective coronary artery surgery were enrolled in the study and assigned either to the on-pump or to the off-pump group. Pre- and postoperative serum levels of OPG and RANKL were evaluated by enzyme-linked immunosorbent assay; gene expression of OPG, RANKL, RANK and NF-κB p50 subunits were determined by real-time polymerase chain reaction in peripheral blood T-cells and monocytes.
  
  
  RESULTS
  Serum levels of OPG significantly increased after surgery in both groups, whereas serum levels of RANKL did not differ over time. T-cells from the on-pump group showed increased gene expression of OPG, RANKL and RANK after the intervention, whereas no mRNA variation for these genes was detected in T-cells from off-pump patients. Gene expression of p50 subunit increased in T-cells and monocytes from both groups.
  
  
  CONCLUSIONS
  Cardiac surgery induces the activation of the OPG/RANKL/RANK pathway; both on- and off-pump procedures are associated with increased postoperative OPG serum levels and up-regulation of the NF-κB p50 subunit.
authors.affiliation: Department of Emergencies and Organ Transplantation, Division of Cardiac Surgery, University Aldo Moro of Bari, Bari, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Galeone
authors.forename: Giacomina
authors.initials: G
authors.lastname: Brunetti
authors.forename: Crescenzia
authors.initials: C
authors.lastname: Rotunno
authors.forename: Angela
authors.initials: A
authors.lastname: Oranger
authors.forename: Silvia
authors.initials: S
authors.lastname: Colucci
authors.forename: Luigi
authors.initials: L
authors.lastname: de Luca Tupputi Schinosa
authors.forename: Alberta
authors.initials: A
authors.lastname: Zallone
authors.forename: Maria
authors.initials: M
authors.lastname: Grano
authors.forename: Domenico
authors.initials: D
authors.lastname: Paparella
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D008297:Male; D008875:Middle Aged; D052002:NF-kappa B p50 Subunit / Q000097:blood* / Q000235:genetics; D053244:Osteoprotegerin / Q000097:blood* / Q000235:genetics; D011446:Prospective Studies; D053245:RANK Ligand / Q000097:blood*; D060888:Real-Time Polymerase Chain Reaction; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood*; D015398:Signal Transduction
chemical_list: D052002:NF-kappa B p50 Subunit; C489548:NFKB1 protein, human; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; C505686:TNFRSF11A protein, human; C505688:TNFSF11 protein, human
keywords: Cardiopulmonary bypass; Inflammatory mediators