interleukin-8 and Heart-Valve-Diseases

To observe the effect of cytokines absorption on renal and respiratory function in patients with open-heart surgery.. 30 patients undergoing valve replacement with cardiopulmonary bypass (CPB) were randomly divided into two groups. A sulfonated polyacrylonitrile hemofilter (AN69) that has been used to absorb cytokines was connected into the efferent limb of CPB in Group A (n = 15), and a cellulose triacetate hemofilter (CT 190G) instead of AN69 was used as controls (Group B, n = 15). The levels of plasma pro-inflammatory (TNF-alpha, IL-6, IL-8) anti-inflammatory cytokines (IL-10, IL-1ra), C-reactive protein (CRP) levels, and post-operation renal and respiratory function were compared between the two groups. Blood samples were analysed for TNF-alpha and IL-6 and IL-8 and C-reactive protein (CRP). The changes in renal, respiratory function were also observed.. (1) At the end of CPB, TNF-alpha 10 ng/L +/- 3 ng/L and IL-6 115 ng/L +/- 22 ng/L levels in Group A were significantly lower than that in Group B 13 ng/L +/- 3 ng/L, 134 ng/L +/- 29 ng/L) respectively (P < 0.05 in all). There is no statistical differences in plasma IL-10 and IL-1ra levels between the two groups. (2) After 24 hours of CPB, the magnitude of increased body temperature, heart rate, white blood cell and plasma CRP in Group A [1.6 degrees C +/- 0.2 degrees C, 15/min +/- 4/min, (17 +/- 3) x 10(9)/L, 56 mg/L +/- 13 mg/L], were significantly lower than that in Group B [2.1 degrees C +/- 0.2 degrees C, 23/min +/- 6/min, (22 +/- 3) x 10(9)/L, 69 mg/L +/- 15 mg/L] respectively (P < 0.05 in all). (3) After 24 hours of CPB, the levels of 24h urinary protein excretion and urinary N-acetyl-beta-D-glucosaminidase (NAG) were significantly lower in Group A when compared to that in Controls (0.20 g/d +/- 0.08 g/d vs 0.30 g/d +/- 0.14 g/d, 28 U/L +/- 11 U/L vs 38 U/L +/- 13 U/L respectively), P < 0.05 in all. The level of creatinine clearance (Ccr) in Group A (68 +/- 7) ml.min(-1).1.73 m(-2) was significantly elevated than that in Group B (57 +/- 11) ml.min(-1).1.73 m(-2) (P < 0.05). (4) One hour after the end of CPB, the magnitude of increased plateau airway pressure (P(Plateau)) and peak airway pressure (P(Peak)) in Group A were significantly lower than that in Controls (P < 0.01 in all). The duration that need mechanical ventilation after operation in Group A (4.9 h +/- 0.6 h) was much shorter than that in Group B (5.8 h +/- 0.8 h, P < 0.05).. Lowering the plasma levels of cytokines by extracorporeal absorption may attenuate systemic inflammatory response and protect lung and kidney function in patients with open-heart surgery.

Topics: Adsorption; Adult; C-Reactive Protein; Cardiac Surgical Procedures; Cytokines; Extracorporeal Circulation; Female; Heart Valve Diseases; Hemofiltration; Humans; Interleukin-10; Interleukin-6; Interleukin-8; Male; Middle Aged; Polypropylenes; Prospective Studies; Treatment Outcome; Tumor Necrosis Factor-alpha

To explore the effect of amrinone and aprotinin on whole-body inflammatory response in the patients with prosthetic valve replacement during perioperative period.. 24 patients undergoing prosthetic valve replacement were randomized to control group (group A, n = 8), aprotinin group (group B, n = 8) and amrinone combined with aprotinin group (group C, n = 8). In the aprotinin group, 3 x 10(6) of aprotinin was added to the priming solution of the extracorporeal circulation (ECC). In the amrinone combined with aprotinin group 3 x 10(6) of aprotinin was added to the priming solution of the ECC and amrinone began with a bolus of 1 mg/kg followed by a maintenance infusion of 8 micrograms/(kg.min). The control group received an equivalent prime volume without aprotinin. Venous blood samples were drawn before the operation, at the end of ECC, 1 hour after the end of ECC, and one day after the operation respectively. Enzyme-linked immunosorbent assay techniques were used to measure each of the cytokines.. Before ECC, there were no differences of the levels of IL-6 and IL-8 among groups (P > 0.05). After ECC, the levels of IL-6 and IL-8 increased significantly in all groups (P < 0.05). The levels on day one after the operation were still higher than those before the operation in all groups (except the level of IL-8 in group C), but no statistical significance was observed. (P > 0.05). At 1 hour after the end of ECC, the level of IL-6 in group B was lower than that in group A, and the level of IL-6 in group C was lower than that in group B, but there was no statistically significant difference (P > 0.05); At the end of ECC, the level of IL-8 in group B was lower than that in group A and the level of IL-8 in group C was lower than that in group B, but no significant difference was noted (P > 0.05). It was also observed that the level of IL-8 was lower in group C than group A or B at 1 hour after the end of ECC.. Although amrinone and aprotinin have antiinflammatory activity, but pump prime only aprotinin or aprotinin combined with amrinone may fall in preventing proinflammatory cytokine release (IL-6, IL-8) completely in patients with prosthetic valve replacement during ECC perioperative period.

Topics: Adult; Amrinone; Aprotinin; Cardiopulmonary Bypass; Cardiotonic Agents; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Interleukin-6; Interleukin-8; Middle Aged; Postoperative Period

Atherosclerosis is a progressive disease characterized by chronic inflammation of the arterial walls, associated with genetic and infectious factors. The present study investigated the involvement of

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Bacterial; Atherosclerosis; Brazil; C-Reactive Protein; Chlamydia Infections; Chlamydia trachomatis; Chlamydophila pneumoniae; Female; Genetic Association Studies; Genetic Predisposition to Disease; Heart Valve Diseases; Humans; Interleukin-10; Interleukin-6; Interleukin-8; Male; Middle Aged; Polymorphism, Genetic; Prevalence; Promoter Regions, Genetic; Risk; Tumor Necrosis Factor-alpha; Young Adult

This study has been conducted in an effort to establish metabolic and inflammatory responses of the myocardium during aortic valve surgery on the beating heart with CPB and continuous coronary sinus perfusion with normothermic blood. Twenty patients, divided into two groups, participated in this study. Conventional aortic valvular operations were performed on first 10 patients, while the second group, consisting of 10 patients as well, was subjected to the operations with CPB on the beating heart with continuously perfusion with blood through coronary sinus. There were total of 14 biological and 6 mechanical valves implanted in aortic position. In this study, cardiac markers and inflammatory mediators IL-8 and TNF, were measured preoperatively and postoperatively. Metabolic changes were documented based on the levels of CK-MB, troponin I, myoglobin and LDH. Inflammatory factors we measured through IL-8 and TNF. All measurements were taken in 6 hour intervals during the initial 48 hours following the operations. The patients of "the beating heart" group had significantly lower dose of markers and cytokines in comparison to those who had undergone the conventional valvular operation. The elimination of the adverse effects of global ischemia produced from reperfusion injury and the similarity to the physiological condition, suggests that the revival of the beating heart procedure is more reasonable. This procedure of valvular surgery on the beating heart can be one of the good surgical options for the high-risk valvular patients.

Topics: Aged; Aortic Valve; Biomarkers; Cardiopulmonary Bypass; Constriction; Female; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Inflammation Mediators; Interleukin-8; L-Lactate Dehydrogenase; Male; Middle Aged; Myocardium; Myoglobin; Perfusion; Troponin I; Tumor Necrosis Factor-alpha

Leukocytopenia can be caused by depressed production, increased peripheral destruction, or excessive peripheral pooling. Leukocyte margination is one of the mechanisms responsible for excessive peripheral pooling. A reversible leukocyte margination is caused by an increase in pro-inflammatory cytokines. However, there are limited data for this phenomenon in clinical conditions. We describe a case of unexpected transient leukocytopenia after exchanging an extracorporeal membrane oxygenation (ECMO) system used to treat severe cardiogenic pulmonary edema. To assess the cause of the leukocytopenia, the serum concentrations of pro-inflammatory cytokines and selectins were measured. The concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-8 were markedly, but transiently, elevated in relation to the leukocytopenia. The transient leukocytopenia with pulmonary margination appeared to be caused by a steep surge of pro-inflammatory cytokines stimulated by hypoxia/reoxygenation during the exchange of the ECMO system. This case may suggest the mechanisms responsible for leukocytopenia in the clinical entity referred to as "systemic inflammatory response syndrome"

Topics: Chordae Tendineae; Cytokines; Dyspnea; Extracorporeal Membrane Oxygenation; Heart Valve Diseases; Humans; Hypoxia; Interleukin-6; Interleukin-8; Intra-Aortic Balloon Pumping; Leukopenia; Male; Middle Aged; Mitral Valve Insufficiency; Positive-Pressure Respiration; Pulmonary Edema; Rupture, Spontaneous; Systemic Inflammatory Response Syndrome; Tumor Necrosis Factor-alpha

The embedding of bacteria in the vegetation of infective endocarditis impedes the penetration of phagocytic cells. IL-8 has a stimulating effect on the immune system, particularly with respect to chemotaxis and activation of granulocytes. Tumor necrosis factor alpha (TNF-alpha) is 1 of the major proinflammatory cytokines. IL-8 and TNF-alpha were visualized by means of immunohistochemistry in paraffin-embedded heart valve biopsies from 6 patients with infective endocarditis who required cardiac surgery during the active phase of the infection. In 5/6 patients there were signs of inflammation, and in these patients IL-8- and TNF-alpha-containing cells were visualized in the heart valve stromas or vegetations. The largest numbers of IL-8-containing cells, and the greatest amount of inflammation, were seen in patients with short preoperative treatment courses. No such relationships were seen with respect to TNF-alpha-containing cells. These observations may suggest that the occurrence of IL-8-containing cells in infected heart valves could be used as a marker of disease activity.

Topics: Adult; Aged; Bacterial Infections; Biomarkers; Biopsy, Needle; Endocarditis, Bacterial; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Heart Valve Diseases; Heart Valves; Humans; Immunohistochemistry; Interleukin-8; Male; Middle Aged; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Tumor Necrosis Factor-alpha

Interleukin-7 (IL-7) and IL-8 productions in 25 children with acute rheumatic fever (ARF) and in 15 children with chronic rheumatic heart disease (CRHD) and in 15 children with streptococcal pharyngitis (SP), were investigated in order to determine whether they have a role in the pathogenesis of rheumatic fever. Significantly higher IL-8 levels were found in ARF patients in the clinically active period. IL-7 concentrations remained unchanged during different stages of rheumatic fever. The decrease of elevated IL-8 concentrations within 3 months and normal IL-8 concentrations in patients with CRHD and SP indicate an excessive production of IL-8, probably by cellular infiltrates in the joint throughout the active period of rheumatic disease.

Topics: Adolescent; Child; Chronic Disease; Female; Heart Valve Diseases; Humans; Interleukin-7; Interleukin-8; Male; Pharyngitis; Rheumatic Fever; Rheumatic Heart Disease; Streptococcal Infections