title: Substantial Increases Occur in Serum Activins and Follistatin during Lung Transplantation.
abstract: Lung transplantation exposes the donated lung to a period of anoxia. Re-establishing the circulation after ischemia stimulates inflammation causing organ damage. Since our published data established that activin A is a key pro-inflammatory cytokine, we assessed the roles of activin A and B, and their binding protein, follistatin, in patients undergoing lung transplantation.
  
  
  
  Sera from 46 patients participating in a published study of remote ischemia conditioning in lung transplantation were used. Serum activin A and B, follistatin and 11 other cytokines were measured in samples taken immediately after anaesthesia induction, after remote ischemia conditioning or sham treatment undertaken just prior to allograft reperfusion and during the subsequent 24 hours.
  
  
  
  Substantial increases in serum activin A, B and follistatin occurred after the baseline sample, taken before anaesthesia induction and peaked immediately after the remote ischemia conditioning/sham treatment. The levels remained elevated 15 minutes after lung transplantation declining thereafter reaching baseline 2 hours post-transplant. Activin B and follistatin concentrations were lower in patients receiving remote ischemia conditioning compared to sham treated patients but the magnitude of the decrease did not correlate with early transplant outcomes.
  
  
  
  We propose that the increases in the serum activin A, B and follistatin result from a combination of factors; the acute phase response, the reperfusion response and the use of heparin-based anti-coagulants.
authors.affiliation: Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Monash University, Clayton, Victoria, Australia.|Hudson Institute of Medical Research, Clayton, Victoria, Australia.
authors.forename: David M
authors.initials: DM
authors.lastname: de Kretser
authors.affiliation: Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Monash University, Clayton, Victoria, Australia.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Bensley
authors.affiliation: Hudson Institute of Medical Research, Clayton, Victoria, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Phillips
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.|Lung Transplant Service, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Bronwyn J
authors.initials: BJ
authors.lastname: Levvey
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.|Lung Transplant Service, Alfred Hospital, Melbourne, Victoria, Australia.|Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Greg I
authors.initials: GI
authors.lastname: Snell
authors.affiliation: Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Enjarn
authors.initials: E
authors.lastname: Lin
authors.affiliation: Hudson Institute of Medical Research, Clayton, Victoria, Australia.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Hedger
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.|Lung Transplant Service, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Robyn E
authors.initials: RE
authors.lastname: O'Hehir
mesh_terms: D028341:Activins / Q000097:blood*; D000328:Adult; D016207:Cytokines / Q000097:blood; D005260:Female; D038681:Follistatin / Q000097:blood*; D006801:Humans; D019194:Ischemic Preconditioning; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D038681:Follistatin; C422405:activin A; C044147:activin B; D028341:Activins
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