Aprotinin and methylprednisolone equally blunt cardiopulmonary bypass-induced inflammation in humans

Gary E. Hill, Anselmo Alonso, John R. Spurzem, Alfred H. Stammers, Richard A. Robbins

Research output: Contribution to journalArticle

204 Scopus citations

Abstract

Cardiopulmonary bypass induces an inflammatory state characterized by tumor necrosis factor-α release. Integrin CD11b is a neutrophil surface adhesive glycoprotein integrin that is rapidly and permanently unregulated by tumor necrosis factor-α exposure. The CD11b integrin is known to be the primary neutrophil integrin responsible for neutrophil lung and myocardial entrapment after cardiopulmonary bypass and subsequent reperfusion injury. Twenty-four adults admitted to the hospital for myocardial revascularization were equally randomized to one of three groups: group A (control), group B (methylprednisolone before cardiopulmonary bypass), and group C (low-dose aprotinin protocol). Blood was collected at three times: (1) baseline, (2) 50 minutes of cardiopulmonary bypass duration, and (3) 30 minutes after cardiopulmonary bypass termination. Neutrophil CD11b integrin expression was measured by fluorescence-activated cell sorter analysis and plasma tumor necrosis factor-αlevels measured by enzyme-linked immunosorbent assay. Group A demonstrated significant ( p < 0.05) increases in CD11b expression at times 2 and 3 when results were compared with those of the same group baseline and with those of groups B and C at similar times. No significant changes were noted between groups B and C at any time. Group A demonstrated a significant ( p < 0.05) increase in levels of tumor necrosis factor-α at time 3 when results were compared with those of the same group baseline and of groups B and C at the same time. No significant changes were noted between groups B and C at any time. These results demonstrate low-dose aprotinin has a similar antiinflammatory effect to that of methylprednisolone in blunting cardiopulmonary bypass-induced systemic tumor necrosis factor-α release and neutrophil integrin CD11b upregulation. (J THORAC CARDIOVASC SURG 1995;110:1658-62).

Original languageEnglish (US)
Pages (from-to)1658-1662
Number of pages5
JournalThe Journal of Thoracic and Cardiovascular Surgery
Volume110
Issue number6
DOIs
StatePublished - Dec 1995

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ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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