Document Detail


Regulated upon activation, normal T-cell expressed and secreted chemokine and interleukin-6 in rheumatic pulmonary hypertension, targets for therapeutic decisions.
MedLine Citation:
PMID:  19932032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent studies have highlighted the possible influence of chemokines and cytokines on several types of pulmonary arterial hypertension (PAH). Increasing interest has also been focussed on their role as a cause of post-cardiopulmonary bypass (CPB) organ dysfunction.
HYPOTHESIS: Chemokines and cytokines are involved in the pathobiology of rheumatic PAH.
METHODS: Serum levels of the chemokine, regulated upon activation, normal T-cell expressed and secreted (RANTES) and the cytokine interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA) in 35 patients with rheumatic mitral valve disease and 10 matched healthy subjects (control group). Eleven patients (31.4%) had severe pulmonary hypertension. Subsequently, 23 patients underwent mitral valve replacement. The relation of RANTES and IL-6 circulating level with postoperative organ dysfunction was analysed through multiple organ dysfunction score (MODS).
RESULTS: Patients with severe PAH have a significantly higher mean serum level of RANTES compared with other patients (6138.6+/-3543.8 pg/ml vs 1818.2+/-475.2 pg/ml, p=0.0003). The serum level of IL-6 in the patients was statistically different from that of the control (378+/-50.8 pg/ml vs 262+/-90.5 pg/ml, respectively, p=0.002). Patients who required postoperative inotropes had higher preoperative and post-CPB levels of both RANTES and IL-6. While patients with postoperative lung dysfunction had higher levels of IL-6 preoperatively and post-CPB and lower levels of RANTES post-CPB.
CONCLUSIONS: RANTES and IL-6 should be investigated as potential therapeutic targets in the control of rheumatic PAH. Improved understanding of the contribution of RANTES and IL-6 to adverse postoperative complications can lead to improved patient outcome.
Authors:
Amany R Serag; Sahar M Hazaa; Ibtesam K Afifi; Naglaa F Ghoname; Amro R Serag
Publication Detail:
Type:  Journal Article     Date:  2009-11-20
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  37     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  853-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Cardiology, Menoufyia University, Shebin El-Kom, Egypt.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Biological Markers / blood
Case-Control Studies
Chemokine CCL5 / blood*
Female
Heart Valve Prosthesis Implantation / adverse effects
Humans
Hypertension, Pulmonary / etiology,  immunology*
Interleukin-6 / blood*
Male
Middle Aged
Mitral Valve Insufficiency / complications,  immunology,  surgery
Mitral Valve Stenosis / complications,  immunology,  surgery
Multiple Organ Failure / etiology,  immunology
Prospective Studies
Rheumatic Heart Disease / complications,  immunology*,  surgery
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/CCL5 protein, human; 0/Chemokine CCL5; 0/Interleukin-6

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