title: Circulating resistin levels are early and significantly increased in deceased brain dead organ donors, correlate with inflammatory cytokine response and remain unaffected by steroid treatment.
abstract: BACKGROUND
  Resistin is a pro-inflammatory adipokine that increases after brain injury (trauma, bleeding) and may initiate an inflammatory response. Resistin was found increased in deceased, brain dead organ donors (DBD) and correlated with delayed graft function after kidney transplantation. The kinetics of resistin during brain death (BD), its impact on the inflammatory response and the influence of several donor variables on resistin levels are still unknown.
  
  
  METHODS
  Resistin along with a panel of Th1/Th2 cytokines [interferon (IFN)-gamma, interleukin (IL)-1beta, IL-2, IL-6, IL-8, IL10, IL-12, IL-13 and tumor necrosis factor (TNF)] was analyzed in 36 DBDs after the diagnosis of BD and before organ procurement and in 12 living kidney donors (LD). The cytokine levels and resistin were analyzed in relation to donor parameters including cause of death, donors' age and steroid treatment.
  
  
  RESULTS
  Resistin levels were higher in DBDs both at BD diagnosis and before organ procurement compared to LD (p < 0.001). DBDs had significantly increased IL-1beta, IL-6, IL-8, IL-10 and TNF levels at both time points compared with LD. In DBDs, resistin at BD diagnosis correlated positively with IL-1beta (rs 0.468, p = 0.007), IL-6 (rs 0.511, p = 0.002), IL-10 (rs 0.372, p = 0.028), IL-12 (rs 0.398, p = 0.024), IL-13 (rs 0.397, p = 0.030) and TNF (rs 0.427, p = 0.011) at procurement. The cause of death, age over 60 and steroid treatment during BD did not affect resistin levels. However, steroid treatment significantly decreased pro-inflammatory cytokines IL-1beta, IL-8, TNF and IFN-gamma at the time of organ procurement.
  
  
  CONCLUSIONS
  Resistin is increased early in DBDs, remains increased throughout the period of BD and correlates strongly with pro-inflammatory mediators. Resistin level, in contrast to cytokines, is not affected by steroid treatment. Resistin increase is related to the BD but is not influenced by age or cause of death. Resistin may be one of the initial triggers for the systemic inflammatory activation seen in DBDs.
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. rille.pullerits@rheuma.gu.se.|Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. rille.pullerits@rheuma.gu.se.
authors.forename: Rille
authors.initials: R
authors.lastname: Pullerits
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. simona.oltean@vgregion.se.
authors.forename: Simona
authors.initials: S
authors.lastname: Oltean
authors.affiliation: Organ Donation Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. anne.floden@vgregion.se.
authors.forename: Anne
authors.initials: A
authors.lastname: Flodén
authors.affiliation: The Transplant Institute, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden. mihai.oltean@surgery.gu.se.|Department of Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. mihai.oltean@surgery.gu.se.
authors.forename: Mihai
authors.initials: M
authors.lastname: Oltean
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001926:Brain Death / Q000097:blood*; D002648:Child; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D052243:Resistin / Q000097:blood*; D013256:Steroids / Q000494:pharmacology*; D018417:Th1 Cells / Q000187:drug effects / Q000378:metabolism; D018418:Th2 Cells / Q000187:drug effects / Q000378:metabolism; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D055815:Young Adult
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; C499624:RETN protein, human; D052243:Resistin; D013256:Steroids