Immune consequences of pediatric and adult cardiovascular surgery: Report of the 7th Leipzig Workshop.
Immune consequences of pediatric and adult cardiovascular surgery: Report of the 7th Leipzig Workshop.
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DOI：
10.1002/cyto.b.10018
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发表时间：
2003-07-01
期刊：
影响因子：
--
通讯作者：
Emmrich, Frank
中科院分区：
文献类型：
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作者：
Tarnok, Attila;Emmrich, Frank
儿童和成人的心血管手术是西半球先天性和后天性缺陷最常见的干预措施之一。近几十年来，心血管手术的风险已大大降低。然而，心脏直视手术对患者来说是有风险的，并可能导致术后并发症，如心包切开术后综合征、毛细血管渗漏综合征或多器官衰竭。为了进一步了解心血管手术的反应，有必要联合医学和自然科学的多个学科的力量。跨学科是莱比锡研讨会的基本概念。研讨会的共识是，心肺转流心血管手术会诱导全身性炎症反应，原因是（a）活化细胞的消除，（B）对局部促炎反应的代偿反应，（c）白细胞介素-10释放，（d）麻醉剂和药物，以及（e）白细胞外渗。随后的促炎反应是对调节炎症反应的手术创伤的反应。新的治疗方法包括将来自外周血的自体内皮祖细胞引入损伤部位。免疫应答的分析和结果预测需要新的分析工具，其允许以多重方式（即，细胞组学），如流式细胞术微珠阵列测定和基于载玻片的细胞术。主要目标是通过细胞学进行预测医学，即，通过分析细胞组结合复杂的数据模式识别进行个体化风险评估。这些发展可能会导致个性化治疗，使患者受益并降低成本。
Cardiovascular surgery in children and adults is among the most common types of interventions in the western hemisphere for innate and acquired defects. In the recent decades, the risk of cardiovascular surgery has been reduced substantially. Nevertheless, open heart surgery is risky for the patient and can lead to postoperative complications such as postpericardiotomy syndrome, capillary leak syndrome, or multiple organ failure. To gain further understanding into the response to cardiovascular surgery, it is necessary to join forces from several disciplines of medicine and natural sciences. Interdisciplinarity is the basic concept of the Leipzig Workshop. The consensus of the workshop was that cardiovascular surgery with cardiopulmonary bypass induces a systemic antiinflammatory response due to (a) elimination of activated cells, (b) compensatory reaction to a local proinflammatory responses, (c) interleukin-10 release, (d) anesthetics and medication, and (e) leukocyte extravasation. The subsequent proinflammatory reaction is the response to surgical trauma modulating the antiinflammatory reaction. Novel therapeutic approaches include the introduction of autologous endothelial progenitor cells from the peripheral blood into the sites of injury. The analysis of immune response and outcome prediction require novel analytical tools that allow fast, accurate, and quantitative determination of the desired parameters in a multiplexed manner (i.e., cytomics), such as flow cytometric microbead array assays and slide-based cytometry. The major goal is predictive medicine by cytomics, i.e., the individualized risk assessment by analyzing the cytome in combination with sophisticated data pattern recognition. These developments may lead to individualized therapy for the benefit of the patient and cost reduction.