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Article
Cardiopulmonary bypass increases coronary IL-8 in diabetic patients without evidence of reperfusion injury
Journal of Surgical Research
  • S. I. Nawas
  • J. C. Doherty
  • W. T. Vigneswaran
  • B. G. Fogelson
  • M. A. McMillen
  • J. L. Ferguson
  • Avadhesh C. Sharma, Philadelphia College of Osteopathic Medicine
  • W. R. Law
Document Type
Article
Publication Date
1-1-1999
Abstract

Background. Endothelin-1 (ET-1) has been shown to be a potent agonist for monocyte production of the neutrophil chemotactic cytokine interleukin-8 (IL-8). We have shown that diabetic patients demonstrate elevated coronary ET-1 after coronary artery bypass grafting (CABG). We hypothesized that these same diabetic patients would manifest elevated coronary IL-8 and conjugated diene concentrations (an index of reperfusion injury). Methods. Sixteen patients [9 nondiabetics and 7 type II diabetics] underwent nonemergent CABG. The two groups did not differ significantly in preoperative ejection fraction, number of vessels bypassed, or cross-clamp time. Coronary sinus samples were obtained prior to cardioplegic arrest (baseline) and at 1 and 15 min after reperfusion periods A and B (A, reperfusion of native coronaries + LIMA; B, reperfusion of saphenous vein grafts in addition to native coronary system + LIMA). Plasma samples were analyzed for IL-8 (ELISA) and conjugated dienes (spectrophotometry). Results. Initially after reperfusion, IL-8 in both groups was significantly lower than precardioplegia values. In reperfusion B, only the diabetic group demonstrated a significant increase in IL-8 concentrations at 1 and 15 min compared to nondiabetics. Conjugated diene levels were significantly higher in diabetics at each time point than nondiabetics. Conclusions. This study demonstrates an early decrease in IL-8 in both groups, most likely related to depressed production secondary to hypothermia. The subsequent elevation in IL-8 only in the diabetic group was seen without concomitant conjugated diene elevation. While no evidence of reperfusion injury was demonstrated in this time frame, the elevation of IL-8 in diabetics after CABG may contribute to later infiltration and associated oxidative damage.

Comments

This article was published in Journal of Surgical Research, Volume 84, Issue 1, Pages 46-50.

The published version is available at http://dx.doi.org/10.1006/jsre.1999.5602.

Copyright © 1999.

Citation Information
S. I. Nawas, J. C. Doherty, W. T. Vigneswaran, B. G. Fogelson, et al.. "Cardiopulmonary bypass increases coronary IL-8 in diabetic patients without evidence of reperfusion injury" Journal of Surgical Research Vol. 84 (1999) p. 46 - 50
Available at: http://works.bepress.com/avadhesh_sharma/68/