What Is the Significance of Perioperative Release of Macrophage Migration Inhibitory Factor in Cardiac Surgery?
What Is the Significance of Perioperative Release of Macrophage Migration Inhibitory Factor in Cardiac Surgery?
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DOI：
10.1089/ars.2012.5015
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发表时间：
2013-07-01
影响因子：
6.6
通讯作者：
Rex, Steffen
中科院分区：
文献类型：
--
作者：
Stoppe, Christian;Werker, Thilo;Rex, Steffen
心脏手术与多效性细胞因子巨噬细胞移动抑制因子（MIF）的释放有关。释放MIF的触发因素尚未阐明。在本研究中，46例择期心脏手术患者随机分为两组，一组采用常规体外循环心脏停搏诱导I/R（cCABG），另一组采用非体外循环心脏停搏诱导I/R（OPCAB）。我们报告，只有接受cCABG的患者显示术后MIF增加（p = 0.024），而两组均显示白细胞介素-6增加。MIF的释放似乎主要由I/R介导，在较小程度上由炎症介导。术后接受cCABG的患者的内源性过氧化物酶活性（p = 0.021）和血清硫氧还蛋白水平（p = 0.003）显著较高。有趣的是，围手术期MIF释放与抗氧化能力增强和术后房颤（p = 0.018）和急性肾损伤（p = 0.048）发生率显著降低相关。本研究强调了心脏手术期间MIF增加对氧化应激反应的作用。基于目前的观察，我们假设术中MIF分泌是由于I/R，并增强了心脏手术期间患者的抗氧化能力。
Cardiac surgery is associated with release of the pleiotropic cytokine macrophage migration inhibitory factor (MIF). The trigger for MIF release has not yet been elucidated. Owing to its intrinsic antioxidative activity, MIF might reduce oxidative stress and protect from myocardial ischemia and reperfusion (I/R) injury.In the present study, patients scheduled for elective cardiac surgery (n = 46) were randomized to undergo coronary artery bypass grafting either conventionally with cardiopulmonary bypass and cardioplegic arrest-induced I/R (cCABG) or in an off-pump procedure (OPCAB) with minimized I/R. We report that only patients who underwent cCABG exhibited a postoperative increase of MIF (p = 0.024), while both groups showed an increase in interleukin-6. MIF release appears to be primarily mediated by I/R and to a lesser extent by inflammation. Endogenous peroxidase activity (p = 0.021) and serum levels of thioredoxin (p = 0.003) were significantly higher in patients who underwent cCABG after surgery. Interestingly, perioperative MIF release was associated with an enhanced antioxidant capacity and a significantly reduced postoperative incidence of atrial fibrillation (p = 0.018) and acute kidney injury (p = 0.048). The present study highlights the role of MIF increase during cardiac surgery in response to oxidative stress. Based on current observations, we hypothesize that intraoperative MIF secretion is due to I/R and enhances the antioxidant capacity in patients during cardiac surgery.