Denizot Y, Feiss P, Nathan N
Laboratoire d'Hématologie Expérimentale, Faculté de Médecine, 2 rue Dr Marcland, Limoges, 87025, France.
Cytokine. 1999 Apr;11(4):301-4. doi: 10.1006/cyto.1998.0428.
In this study the authors assessed the sequential release of lipid mediators (TXB2, PGE2, 6-keto-PGF1alpha, LTB4, LTC4, PAF), pro-inflammatory cytokines (IL-6, IL-8, TNF-alpha) and anti-inflammatory cytokines (IL-4, IL-10) in 17 patients undergoing coronary artery bypass graft (CABG) with extracorporeal circulation (ECC). Time course of appearance of inflammatory mediators revealed the early and transient increase in lipid mediator plasma concentrations (6-keto-PGF1alpha, LTB4, LTC4, PAF) whereas cytokines (IL-6, IL-8, IL-10) were involved only in late pre- and post-operative periods. No variation of TXB2, PGE2, IL-4 and TNF-alpha levels were found. No correlation was documented between the levels of lipid mediators and pro- or anti-inflammatory cytokines suggesting that lipidic compounds are not implicated in the genesis of cytokines which appear much later involved. Despite the common use of high doses of aprotinin (a non-specific enzyme inhibitor) in hope to abrogate the inflammatory response to cardiopulmonary bypass procedure, this study reports the persistent release of several inflammatory compounds that might be involved in the post-CABG multiple organ failure syndromes.
在本研究中，作者评估了17例接受体外循环（ECC）冠状动脉搭桥术（CABG）患者体内脂质介质（TXB2、PGE2、6-酮-PGF1α、LTB4、LTC4、PAF）、促炎细胞因子（IL-6、IL-8、TNF-α）和抗炎细胞因子（IL-4、IL-10）的顺序释放情况。炎症介质出现的时间进程显示，脂质介质血浆浓度（6-酮-PGF1α、LTB4、LTC4、PAF）早期短暂升高，而细胞因子（IL-6、IL-8、IL-10）仅在术前和术后晚期出现变化。未发现TXB2、PGE2、IL-4和TNF-α水平有变化。脂质介质水平与促炎或抗炎细胞因子水平之间未发现相关性，这表明脂质化合物与后期出现的细胞因子的产生无关。尽管通常使用高剂量的抑肽酶（一种非特异性酶抑制剂）以消除对体外循环手术的炎症反应，但本研究报告了几种炎症化合物的持续释放，这些化合物可能与冠状动脉搭桥术后多器官功能衰竭综合征有关。
