Cytokine profile after lung transplantation: Correlation with allograft injury - Discussion
Cytokine profile after lung transplantation: Correlation with allograft injury - Discussion
复制标题
DOI：
10.1016/j.athoracsur.2005.11.053
复制
发表时间：
2006-05-01
影响因子：
4.6
通讯作者：
Fullerton, DA
中科院分区：
文献类型：
--
作者：
Mathur, A;Baz, M;Fullerton, DA
背景。 10% 至 60% 的肺移植受者会出现肺移植后再灌注水肿 (PLTRE) 及其更严重的形式，即原发性移植物衰竭 (PGF)。我们假设 PLTRE 和 PGF 与促炎级联升高有关，并且同种异体移植物将是循环中细胞因子出现的来源。方法。在基线以及再灌注后 4、8 和 24 小时获取肺动脉和全身动脉样本。肺移植后再灌注水肿和PGF分别定义为72小时后PaO2/FiO(2)低于300时有轻度或中度浸润，或低于200时有严重浸润和呼吸机依赖。通过免疫测定法测定肿瘤坏死因子α (TNF α)、白细胞介素(IL)-6、IL-8和IL-10浓度。 结果。对 15 名单肺受者和 6 名双侧肺受者进行了研究。 6 名 (29%) 患有 PLTRE，4 名 (19%) 患有 PGF；这些患者的血浆 IL-6、IL-8 和 IL-10 浓度总体升高（所有 p < 0.05）。亚组分析显示，与 PLTRE 患者相比，PGF 患者的 IL-6、IL-8 和 IL-10 水平显着升高（所有 p < 0.01）。在 PGF 组中，全身样本中的 TNF α 和 IL-10 浓度显着高于肺动脉样本中的浓度 (p < 0.05)。结论。患有PLTRE和PGF的患者表现出IL-6、IL-8和IL-10浓度的分级增加。 PGF 患者总体上具有较高的 TNF α 和 IL-10 全身动脉浓度，这与同种异体移植物是这种细胞因子产生的来源一致。
Background. Post-lung transplant reperfusion edema (PLTRE) and its more severe form, primary graft failure (PGF), occur in 10% to 60% of lung transplant recipients. We hypothesized that PLTRE and PGF would be associated with an elevated proinflammatory cascade and that the allograft would be the source of cytokine appearance in the circulation.Methods. Pulmonary arterial and systemic arterial samples were obtained at baseline and at 4, 8, and 24 hours after reperfusion. Post-lung transplant reperfusion-edema and PGF were defined as PaO2/FiO(2) less than 300 with a mild or moderate infiltrate, or less than 200 with a severe infiltrate and ventilator dependence after 72 hours, respectively. Tumor necrosis factor alpha (TNF alpha), interleukin (IL)-6, IL-8, and IL-10 concentrations were determined by immunoassay.Results. Fifteen single and 6 bilateral lung recipients were studied. Six (29%) had PLTRE and 4 (19%) had PGF; these patients had an overall elevation in plasma IL-6, IL-8, and IL-10 concentrations (all p < 0.05). Subgroup analysis revealed a significantly greater elevation in IL-6, IL-8, and IL-10 levels in PGF patients (all p < 0.01) versus PLTRE. In the PGF group, TNF alpha and IL-10 concentrations were significantly greater in the systemic versus the pulmonary arterial samples (p < 0.05).Conclusions. Patients with PLTRE and PGF exhibited graded increases in IL- 6, IL- 8, and IL- 10 concentrations. The PGF patients had higher TNF alpha and IL-10 systemic arterial concentrations overall, consistent with the allograft being a source of this cytokine production.