Are lipid mediators implicated in the production of pro- and anti-inflammatory cytokines during cardiopulmonary bypass graft with extracorporeal circulation?

In this study the authors assessed the sequential release of lipid mediator s (TXB2, PGE(2), 6-keto-PGF(1 alpha), LTB4, LTC4, PAF), pro-inflammatory cy tokines (IL-6, IL-8, TNF-alpha) and anti-inflammatory cytokines (IL-4, IL-1 0) in 17 patients undergoing coronary artery bypass graft (CABG) with extra corporeal circulation (ECC). Time course of appearance of inflammatory medi ators revealed the early and transient increase in lipid mediator plasma co ncentrations (6-keto-PGF(1 alpha), LTB4, LTC4, PAF) whereas cytokines (IL-6 , IL-8, IL-10) were involved only in late pre- and post-operative periods. No variation of TXB2, PGE(2), IL-4 and TNF-alpha levels were found. No corr elation was documented between the levels of lipid mediators and pro- or an ti-inflammatory cytokines suggesting that lipidic compounds are not implica ted in the genesis of cytokines which appear much later involved. Despite t he common use of high doses of aprotinin (a non-specific enzyme inhibitor) in hope to abrogate the inflammatory response to cardiopulmonary bypass pro cedure, this study reports the persistent release of several inflammatory c ompounds that might be involved in the post-CABG multiple organ failure syn dromes. (C) 1999 Academic Press.