Proinflammatory and antiinflammatory cytokines after cardiac operation: Different cellular sources at different times
Proinflammatory and antiinflammatory cytokines after cardiac operation: Different cellular sources at different times
复制标题
DOI：
10.1016/s0003-4975(02)03658-5
复制
发表时间：
2002-08-01
影响因子：
4.6
通讯作者：
Markewitz, A
中科院分区：
文献类型：
--
作者：
Franke, A;Lante, W;Markewitz, A
背景资料。心脏手术会在免疫系统内产生实质性的变化，这可能会导致术后并发症。然而，促炎和抗炎反应之间的相互作用以及参与这一过程的细胞还不完全清楚。因此，我们调查了促炎症和抗炎细胞因子的血清水平和合成模式。采用单核细胞、巨噬细胞和淋巴细胞混合细胞培养和淋巴细胞纯化培养，检测25例心脏手术患者术前(0天)、术后1天、术后3天和术后5天的血清IL-5、IL-6、IL-10、肿瘤坏死因子-α和干扰素-γ的水平和产生情况，并与10名健康志愿者进行比较。术后第1天血清和混合细胞培养IL-6、肿瘤坏死因子-α和IL-10水平升高，而淋巴细胞培养水平下降。术后第5天达到基线水平。术后第3天和第5天，干扰素-γ水平保持不变，而IL-5水平升高。两种细胞培养的细胞培养合成均受到显著抑制，混合细胞培养的细胞培养合成在术后第3天恢复到基线水平。术后第5天淋巴细胞产生干扰素-γ受到抑制，而IL-5在术后第5天恢复到术前水平。心脏手术可诱导双相免疫反应。第一阶段(术后第1天)似乎代表先天免疫系统在术后第3天回到基线的促炎和抗炎反应。第二阶段(术后第5天)可能代表适应性免疫系统的反应，以抗炎性反应为特征。这可能解释了为什么全身炎症反应在心脏手术后立即发生，而感染发生在之后。
Background. Cardiac operation produces substantial alterations within the immune system, which possibly predispose postoperative complications. However, the interplay between proinflammatory and antiinflammatory reactions and the cells involved in this process are not completely clear. Therefore, we investigated serum levels, as well as synthesis patterns, of proinflammatory and antiinflammatory cytokines.Methods. Serum levels and production of interleukin (IL) IL-5, IL-6, IL-10, tumor necrosis factor-alpha, and interferon-gamma, using a mixed cell culture, (ie, monocytes, macrophages, and lymphocytes), as well as a purified lymphocyte culture were measured preoperatively (day 0), on postoperative day 1, on postoperative day 3, and on postoperative day 5 in 25 patients undergoing cardiac operations and were compared with 10 healthy volunteers.Results. Serum level and mixed cell culture, production of IL-6, tumor necrosis factor-a, and IL-10 increased on postoperative day 1, but decreased in lymphocyte culture. Base line values were reached on postoperative day 5. Interferon-gamma serum levels remained unchanged, whereas IL-5 serum levels increased on postoperative days 3 and 5. Cell culture synthesis showed a significant suppression for both mediators in both cell cultures, which returned to baseline on postoperative day 3 in mixed cell culture. Interferon-gamma production by lymphocytes was suppressed until postoperative day 5, whereas IL-5 returned to preoperative values on postoperative day 5.Conclusions. Cardiac operation induces a biphasic immune response. The first phase (postoperative day 1) appears to represent the proinflammatory and antiinflammatory reaction of the innate immune system returning to base line on postoperative day 3. The second phase (postoperative day 5) may represent the response of the adaptive immune system and is characterized by an antiinflammatory type of reaction. This may explain why the systemic inflammatory response occurs immediately after cardiac operation, whereas infections occur later.