Pentoxifylline Affects Cytokine Reaction in Cardiopulmonary Bypass
DOI:
https://doi.org/10.1532/HSF98.20061090Abstract
Background. Cardiac surgery is associated with an inflammatory response that may cause myocardial dysfunction after cardiopulmonary bypass. We examined the efficacy of pentoxifylline to attenuate the cardiopulmonary bypass-induced inflammatory response during heart operations.
Methods. In a prospective, randomized study, 30 patients undergoing coronary artery bypass graft surgery received either pentoxifylline (group P, n = 15) (continuous infusion of 1.5 mg/kg per hour during operation) or not (group C [control], n = 15). Blood samples for measurements of tumor necrosis factor (TNF)-?, interleukin (IL)-6, IL-8, and IL-10 were taken from the arterial line in both groups at 5 different time points.
Results. TNF-?, IL-6, and IL-8 plasma levels increased in both groups after cardiopulmonary bypass, with a higher increase in the control group (P < .05).
Conclusions. Our results indicate that pentoxifylline infusion during cardiac surgery inhibits the proinflammatory cytokine release caused by cardiopulmonary bypass.
References
Al-Ruzzeh S, Hoare G, Marczin N, et al. 2004. Off-pump coronary artery bypass surgery is associated with reduced neutrophil activation as measured by the expression of CD11b. Heart Surg Forum 6:89-93.nAleshin A, Sawa Y, Ono M, Funatsu T. 2004. Myocardial protective effect of FR167653; a novel cytokine inhibitor in ischemic-reperfused rat heart. Eur J Cardiothorac Surg 26:974-80.nAmbrus JL, Stadler S, Kulaylat M. 1995. Hemorrheologic effects of metabolites of pentoxifylline (Trental). J Med 26:65-75.nBittar MN, Carey JA, Barnard J, et al. 2005. Interleukin 6 G-174C polymorphism influences outcome following coronary revascularization surgery. Heart Surg Forum 8:E140-5.nBoldt J, Brosch C, Lehmann A, Haisch G, Lang J, Isgro F. 2001. Prophylactic use of pentoxifylline on inflammation in elderly cardiac surgery patients. Ann Thorac Surg 71:1524-9.nEl Azab SR, Rosseel PMJ, de Lange JJ, Groenveld ABJ. 2002. Dexamet-hazone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery. Br J Anaesth 88:496-501.nEdmunds LH Jr. 1997. Extracorporeal perfusion. In: Edmunds LH Jr, ed. Cardiac Surgery in the Adult. New York: McGraw-Hill; 255-94.nEdmunds NJ, Lal H, Woodward B. 1999. Effects of tumour necrosis factor-alpha on left ventricular function in the rat isolated perfused heart: possible mechanisms for a decline in cardiac function. Br J Pharmacol 126:189-96.nEge T, Arar C, Canbaz S, et al. 2004. The importance of aprotinin and pentoxifylline in preventing leukocyte sequestration and lung injury caused by protamine at the end of cardiopulmonary bypass surgery. Thorac Cardiovasc Surg 52:10-5.nFrangogiannis NG, Smith CW, Entman ML. 2002. The inflammatory response in myocardial infarction. Cardiovasc Res 53:31-47.nGessler P, Pfenninger J, Pfammatter JP, Carrel T. 2003. Plasma levels of interleukin-8 and expression of interleukin-8 receptors on circulating neutrophils and monocytes after cardiopulmonary bypass in children. J Thorac Cardiovasc Surg 126:718-25.nGiomarelli P, Scolletta S, Borrelli E, Biagioli B. 2003. Myocardial and lung injury after cardiopulmonary bypass: role of interleukin (IL)-10. Ann Thorac Surg 76:117-23.nGol MK, Nisanoglu V, Iscan Z, et al. 2002. Inhibition of systemic inflammatory response with sodium nitroprusside in open heart surgery. J Cardiovasc Surg 43:803-9.nJi Q, Zhang L, Jia H, Xu J. 2004. Pentoxifylline inhibits endotoxin-induced NF-kappa B activation and associated production of proinflammatory cytokines. Ann Clin Lab Sci 34:427-36.nLaffey JG, Boylan JF, Cheng DC. 2002. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anes-thesiology 97:215-52.nLarmann J, Theilmeier G. 2004. Inflammatory response to cardiac surgery: cardiopulmonary bypass versus non-cardiopulmonary bypass surgery. Best Pract Res Clin Anaesthesiol 18:425-38.nMiller BE, Levy JH. 1997. The inflammatory response to cardiopulmonary bypass. J Cardiothorac Vasc Anesth 11:355-66.nSamankatiwat P, Samartzis I, Lertsithichai P, Stefanou D. 2003. Leucocyte depletion in cardiopulmonary bypass: a comparison of four strategies. Perfusion 18:95-105.nSchmartz D, Tabardel Y, Preiser JC, Barvais L. 2003. Does aprotinin influence the inflammatory response to cardiopulmonary bypass in patients? J Thorac Cardiovasc Surg 125:184-90.nSzefner J. Control and treatment of hemostasis in cardiovascular surgery. 1995. The experience of La Pitie hospital with patients on total artificial heart. Int J Artif Organs 18:633-48.nTsang GM, Allen S, Pagano D. 1996. Pentoxifylline preloading reduces endothelial injury and permeability in cardiopulmonary bypass. Asaio J 42:429-34.nUstunsoy H, Sivrikoz MC, Tarakcioglu M, Bakir K. 2006. The effects of pentoxifylline on the myocardial inflammation and ischemia-reperfusion injury during cardiopulmonary bypass. J Card Surg 21:57-61.nWan S, LeClerc JL, Vincent JL. 1997. Inflammatory response to cardiopulmonary bypass. Chest 112:676-93.n
Published
How to Cite
Issue
Section
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).
