lactoferrin and Heart-Diseases

Heparin-coated circuits attenuate the systemic inflammatory response to cardiopulmonary bypass. The present study compares two different heparin coatings in terms of the release of endothelin-1 and neutrophil glycoproteins.. Forty low-risk patients undergoing coronary artery bypass grafting were investigated, having cardiopulmonary bypass with a Duraflo II heparin-coated circuit (n = 10), an identical but uncoated circuit (n = 10), a Carmeda BioActive Surface heparin-coated circuit (n = 10), or an identical but uncoated circuit (n = 10). A standard systemic heparin dosage was used in all patients. Endothelin-1 and the neutrophil glycoproteins lactoferrin and myeloperoxidase were quantified throughout the operation and 3 hours postoperatively.. Enhanced plasma levels of endothelin-1, lactoferrin, and myeloperoxidase were observed during and after uncoated cardiopulmonary bypass, but this was not associated with clinical side effects. Compared with the respective uncoated controls, Duraflo II attenuated only the lactoferrin levels, whereas Carmeda BioActive Surface was associated with lower levels of both endothelin-1, lactoferrin, and myeloperoxidase. Of the two heparin coatings, Carmeda BioActive Surface proved more effective than Duraflo II in attenuating the levels of these substances.. The plasma levels of endothelin-1, lactoferrin, and myeloperoxidase increase during cardiopulmonary bypass in coronary artery bypass grafting, but this has no clinical side effects in low-risk patients. The increase is attenuated using heparin-coated extracorporeal circuits, and then more effectively by Carmeda BioActive Surface than by Duraflo II.

Topics: Cardiopulmonary Bypass; Coronary Artery Bypass; Endothelin-1; Enzyme-Linked Immunosorbent Assay; Female; Fibrinolytic Agents; Heart Diseases; Heparin; Humans; Lactoferrin; Male; Neutrophil Activation; Peroxidase

The aim of this investigation was to monitor proliferation and cytokine production by peripheral blood mononuclear cells (PBMC) of patients subjected to cardiac surgery. Another goal was to establish regulatory effects of lactoferrin (LF) on these immune reactions in vitro. PBMC were tested before, during surgery and on day 1 and day 8-10 following operation. In control donors, low spontaneous and phytohemagglutinin (PHA)-induced proliferation of PBMC, as well as lipopolysaccharide (LPS)-induced TNF-alpha secretion was stimulated by LF, but high production of this cytokine was inhibited. In patients, the proliferation of PBMC and the ability to produce IL-6 TNF-alpha by these cells underwent characteristic changes depending on preoperative immune reactivity of patients. In general, low, preoperative reactivity of PBMC showed a tendency to increase within the monitoring period whereas moderate/high responsiveness was diminishing. LF had, in majority of cases, a down-regulatory effect on the proliferative response, best pronounced in patients of high/moderate preoperative response. Similarly, LF exhibited, in general, an inhibitory effect on LPS-induced IL-6 production. In terms of TNF-alpha production, a considerable up-regulatory effect of LF, particularly in low responding patients was of a special interest. In summary, we suggest that LF may play a role in lowering the immune response of patients to surgery and promoting tissue regeneration.

Topics: Adult; Cell Division; Cells, Cultured; Female; Gene Expression Regulation; Heart Diseases; Humans; Interleukin-6; Lactoferrin; Leukocytes, Mononuclear; Lipopolysaccharides; Male; Middle Aged; Phytohemagglutinins; Postoperative Period; Tumor Necrosis Factor-alpha

Leukotriene B4 has been shown to play a role in the systemic inflammatory response after cardiopulmonary bypass in experimental animal models; however, the importance of this mediator in human beings undergoing cardiac operations has not been established.. The neutrophils of ten patients undergoing coronary artery bypass grafting with cardiopulmonary bypass were studied for their ability to generate leukotrienes at the time of the induction of anesthesia, the institution of cardiopulmonary bypass, the removal of the aortic crossclamp, at the end of the operation, on admission to the intensive care unit, and on postoperative days 1 and 2. After cardiopulmonary bypass, the generation of chemotactic leukotrienes rose significantly and remained elevated on the first postoperative day compared with prebypass values (prebypass 133.8 +/- 10.7 versus postbypass 192.7 +/- 19.2 [p < 0.05] and first postoperative day 196.6 +/- 13.8 [p < 0.05]). The increases in plasma complement and lactoferrin levels, although significant, were not sustained. In addition to the neutrophil count, the potential leukotriene and oxygen radical produced was significantly increased, and this increase was correlated with postoperative length of stay.. These observations support the laboratory data documenting that the rise in leukotriene generation after cardiopulmonary bypass includes human patients.

Topics: Aged; Cardiopulmonary Bypass; Coronary Artery Bypass; Female; Free Radicals; Heart Diseases; Humans; Lactoferrin; Leukocyte Count; Leukotrienes; Male; Middle Aged; Neutrophils; Postoperative Period