The antiendotoxin agent taurolidine potentially reduces ischemia/reperfusion injury through its metabolite taurine
The antiendotoxin agent taurolidine potentially reduces ischemia/reperfusion injury through its metabolite taurine
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DOI：
10.1016/j.surg.2010.01.006
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发表时间：
2010-09-01
期刊：
影响因子：
3.8
通讯作者：
Redmond, Henry P.
中科院分区：
文献类型：
--
作者：
Doddakula, Kishore K.;Neary, Peter M.;Redmond, Henry P.
背景心脏搭桥术导致缺血/再灌注（I/R）诱导的内毒素血症。我们进行了一项前瞻性随机试验，研究牛磺罗定（一种具有抗氧化和膜稳定特性的抗内毒素药物）对冠状动脉旁路移植术（CABG）患者的影响。共60例接受CABG的患者随机分为4组。A、B组采用St托马斯医院冷晶体停搏液，C、D组采用冷血停搏液。A组和C组接受生理盐水的安慰剂输注，而B组和D组静脉内给予牛磺罗定。评估围手术期促炎和抗炎细胞因子（白细胞介素[IL]-6和IL-10）诱导的心律失常以及I/R。与安慰剂相比，在晶体心脏停搏液患者中给予牛磺罗定导致主动脉开放后24小时血清IL-6显著降低和血清IL-10升高（P < .0001）。虽然没有统计学显著性，但这种血清IL-6降低的趋势反映在血液心脏停搏液患者中（P = 0.068）。与安慰剂相比，牛磺罗定治疗还显著降低了晶体停搏液患者I/R诱导的心律失常（P <0.003）。与安慰剂组相比，含血停搏液组的I/R诱发心律失常较少，但差异较小，无统计学意义（P = 0.583）。这项研究表明，牛磺罗定在CABG患者中的给药诱导了与心律失常显著减少相关的强效抗炎反应。（Surgery 2010;148：567-72.）
Background. Cardiopulmonary bypass results in ischemia/reperfusion (I/R)-induced endotoxemia. We conducted a prospective randomized trial to investigate the effect of taurolidine, an antiendotoxin agent with antioxidant and membrane-stabilizing properties, on patients undergoing coronary artery bypass grafting (CABG).Methods. A total of 60 patients undergoing CABG were randomized into 4 groups. St Thomas' Hospital cold crystalloid cardioplegia was used in groups A and B; and cold blood cardioplegia in groups C and D. Groups A and C received a placebo infusion of normal saline, whereas groups B and D were administered intravenous taurolidine. Arrhythmias induced by pro- and anti-inflammatory cytokines (interleukin [IL]-6 and IL-10), and I/R were assessed perioperatively.Results. Administration of taurolidine in crystalloid cardioplegia patients resulted in a significant decrease in serum IL-6 and an increase in serum IL-10 at 24 hours postaortic unclamping compared to placebo (P < .0001). Although not statistically significant, this trend in serum IL-6 decrease was mirrored in the blood cardioplegia patients (P = .068). Taurolidine treatment also significantly decreased I/R-induced arrhythmias compared to placebo in the crystalloid cardioplegia patients (P < .003). There were fewer I/R-induced arrhythmias compared to placebo in the blood cardioplegia patients; the difference, however, was marginal and not statistically significant (P = .583).Conclusion. This study demonstrates that administration of taurolidine in CABG patients induces a potent anti-inflammatory response that is associated with a significant decrease in arrhythmias. (Surgery 2010;148:567-72.)