Genotype and interleukin-10 responses after cardiopulmonary bypass |
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Authors: | Galley H F Lowe P R Carmichael R L Webster N R |
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Institution: | Academic Unit of Anaesthesia and Intensive Care, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK |
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Abstract: | Background. The pro- and anti-inflammatory cytokine balancehas been implicated in outcome from inflammatory conditions,and cardiopulmonary bypass is associated with a marked inflammatoryresponse. Interleukin-10 (IL-10) is an anti-inflammatory cytokineand levels have been shown to be highest in those patients whodevelop sepsis after trauma or surgery. IL-10 levels vary betweenindividuals and genotype may dictate the IL-10 response. Wetherefore investigated IL-10 genotype, circulating IL-10 concentrationsand outcome in terms of organ dysfunction 24 h after cardiopulmonarybypass. Methods. Blood samples were obtained from 150 patients before,and 3, and 24 h after cardiopulmonary bypass. IL-10 wasmeasured by enzyme immunoassay. The single nucleotide polymorphismat 1082 base pairs was detected by restriction fragmentlength polymorphism analysis. Post-bypass organ system dysfunctionwas defined prospectively. Results. IL-10 concentrations were increased 3 h afterbypass (P<0.0001) and were still increased at 24 h (P<0.0001).Homozygosity for the G allele was associated with lower median(range) maximal IL-10 levels at 3 h (44 (13136)pg ml1) compared with the A allele (118 (39472)pg ml1; P=0.042). Those patients who developed atleast one organ dysfunction (n=33) had higher IL-10 levels 3 hafter surgery (242 (18694) pg ml1) comparedwith those without organ dysfunction (77 (7586) pg ml1;P=0.001, n=117). Conclusions. The G allele of the 1082 base pair singlenucleotide polymorphism in the IL-10 gene is associated withlower IL-10 release after cardiopulmonary bypass. High levelsof IL-10 secretion are associated with organ dysfunction 24 hafter surgery. Br J Anaesth 2003; 91: 4246 |
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Keywords: | complications organ dysfunction polypeptide cytokines interleukin-10 heart cardiopulmonary bypass |
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