The comparative proteomic analysis of serum cytokine expression in acute lung injury patients in peri-operative stage of liver transplantation

Abstract

To investigate the characteristics of serum cytokine expression in acute lung injury (ALI) patients in peri-operative stage of liver transplantation with the aim of setting the basis for screening the early markers and treatment targets of ALI. Four male patients with ALI occurring in peri-operative stage of liver transplantation for hepatitis B liver cirrhosis, with no lung, renal, or brain abnormality, without difference in clinical findings (urine volume, blood loss, ascites, amount of blood transfusion, operation time, anhepatic time, the use of vaso-active drugs, diuretics and condition of circulation) were included for study. Blood was taken after anesthesia, 3 hours and 24 hours after new liver. RayBio human antibody array was used to analyze the cytokine expression. Compared with healthy people, in the patients with ALI in peri-operative stage of liver transplantation, upregulation of some cytokines appeared as early as after anesthesia, including interleukins (IL-3, IL-6, IL-12 p40, IL-12 p70), monocyte chemoattractant protein-2 (MCP-2), macrophage-colony stimulating factor (M-CSF), monokine induced by interferon-gamma (MIG), macro-phage inflammatory protein-1 alpha (MIP-1 alpha), soluble tumor necrosis factor receptor I (sTNFR I), especially sTNFR II which showed even stronger expression, while normal T cells expression and secretory factor (RANTES) and platelet-derived growth factor-BB (PDGF-BB) showed downregulation in expression. Some more cytokines showed upregulation in expression at neohepatic 3 hours, especially IL-12 p70, sTNFR I, sTNFR II showed upregulation, while RANTES, PDGF-BB and IL-1 alpha showed downregulation in expression. The number of cytokines showing upregulation was significantly increased at neohepatic 24 hours. Compared with those at neohepatic 3 hours, eotaxin, IL-1 alpha, IL-1 beta, IL-4, IL-15, MCP-2 showed significantly higher upregulation at neohepatic 24 hours, and among them IL-3 and IL-6 especially IL-2 showed even more upregulation in expression. There are changes in expression of different kinds of cytokines in various extent before operation, at neohepatic 3 hours and neohepatic 24 hours. Some of them may be considered as important early markers and treatment targets. Further researches with large samples would be necessary to elucidate the clinical implication.