Gender-related plasma levels of progesterone, interleukin-8 and interleukin-10 during and after cardiopulmonary bypass in infants and children

Background It is known that proinflammatory and anti-inflammatory cytokines are released during and after cardiopulmonary bypass (CPB) in infants and children. Sex steroids are known to have immunomodulatory functions, and re lease of the anti-inflammatory cytokine IL-10 is stimulated by progesterone in vitro. The purpose of the present study was to investigate the plasma l evels of progesterone, IL-8 (proinflammatory cytokine) and IL-10, and to re late them to sex and postoperative morbidity. Method Eighteen infants and children (eight female) undergoing CPB were pro spectively studied. Plasma levels of progesterone, IL-8 and IL-10 were dete rmined before and 10 min after the start of CPB, and immediately after CPB; and 6 h, 24 h, 3 days and 7 days postoperatively. Organ dysfunction was id entified on the basis of arbitrarily defined criteria. Results After CPB, all patients showed significant increases in plasma leve ls of progesterone, IL-8 and IL-10. Plasma levels of IL-10 were significant ly higher in female patients, except for during the immediate postoperative period. According to the criteria used, six out of 10 male patients, but n one of the female patients developed multiple organ dysfunction (MOD). Conclusion The present study shows that CPB induces a significant and marke d increase in plasma levels of progesterone in infants and children. Studie s of administration of progesterone-blocking substances to male and female animals may help to elucidate the roles of sex and progesterone in the sett ing of CBP.