Abstract
Aim. The changes of blood cytokine profile in patients with ischemic heart disease (IHD) with different development rates and formation of systemic inflammatory response (SIR) after coronary artery bypass grafting by using cardiopulmonary bypass (CPB) are analyzed in this article. Materials and methods. The patients with slowly progressive of IHD (20 patients) and rapidly progressive of IHD (20 patients) were examined. The concentration of interleukine (IL) 1β, IL-1ra, IL-4, IL-6, IL-8 and tumor necrosis factor (TNF) α in blood plasma were evaluated by ELISA at patients with IHD before surgery and at 6 and 24 h after surgery. The results of the study showed that concentration of IL-1β, IL-6, IL-8, TNF-α and IL-1ra in blood plasma increases in patients with IHD of both groups before surgery. The concentration of IL-4 in the blood saved in the normal range before the operation in the case of slow disease progression, but maximum increase in content of proinflammatory (TNF-α, IL-6) and anti-inflammatory (IL-4, IL-1ra) cytokines in the blood and the IL-1ra/IL-1β ratio was detected in a rapidly developing of IHD. It was noticed that after coronary artery bypass grafting in patients with long history case of IHD the content of IL-1β, IL-8, TNF-α, IL-1ra, IL-4 increased with a normalization of the IL-6 concentration in the blood; in patients with a short period of IHD increase of IL-1 concentration and high content of IL-6 are combined with remaining unchanged level of IL1β, IL-8, IL-4 and negative dynamics of the TNF-α concentration in the blood. Thus, the operation in the СРВ in the case of IHD with prolonged course induces the formation of SIR, typical for acute inflammation, and coordinated anti-inflammatory response, and in the case of short period of coronary disease progress this operation causes SIR, characteristic for chronic inflammation, and uncoordinated anti-inflammatory response.
Highlights
The concentration of interleukine (IL) 1β, IL-1ra, IL-4, IL-6, IL-8 and tumor necrosis factor (TNF) α in blood plasma were evaluated by ELISA at patients with ischemic heart disease (IHD) before surgery and at 6 and 24 h after surgery
The results of the study showed that concentration of IL-1β, IL-6, IL-8, TNF-α and IL-1ra in blood plasma increases in patients with IHD of both groups before surgery
The concentration of IL-4 in the blood saved in the normal range before the operation in the case of slow disease progression, but maximum increase in content of proinflammatory (TNF-α, IL-6) and anti-inflammatory (IL-4, IL-1ra) cytokines in the blood and the IL-1ra/IL-1β ratio was detected in a rapidly developing of IHD
Summary
Для цитирования: Чумакова С.П., Уразова О.И., Шипулин В.М., Новицкий В.В., Хардикова С.А. Цель исследования – определить характер изменений цитокинового профиля крови при формировании системной воспалительной реакции (СВР) у больных ишемической болезнью сердца (ИБС) с разными темпами развития заболевания после коронарного шунтирования с применением искусственного кровообращения (ИК). При этом в случае медленного прогрессирования заболевания концентрация IL-4 в крови сохранялась в пределах нормы, в то время как при быстро развивающейся ИБС обнаруживалось максимально выраженное увеличение содержания провоспалительных (TNF-α, IL-6) и противовоспалительных (IL-4, IL-1rа) цитокинов в крови и соотношения IL-1rа/IL-1β. После коронарного шунтирования у больных ИБС с длительным анамнезом заболевания отмечалось увеличение содержания IL-1β, IL-8, TNF-α, IL-1rа, IL-4 при нормализации концентрации IL-6 в крови; у пациентов с коротким периодом развития ИБС – рост концентрации IL-1rа, высокое содержание IL-6 при сохраняющемся без изменений уровне IL-1β, IL-8, IL-4 и отрицательной динамике концентрации TNF-α в плазме крови. Ключевые слова: цитокины, системная воспалительная реакция, ишемическая болезнь сердца, искусственное кровообращение
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