Interleukin-10 and interleukin-1 receptor antagonists increase during cardiac surgery.

BACKGROUND It has been reported that inflammatory cytokines such as interleukin-8 and 6 (IL-8, IL-6) increase during cardiac surgery and caused postoperative cardiac dysfunction. Therefore, it is important to investigate changes of suppressive cytokines such as IL-10, interleukin-4 (IL-4) and interleukin-1 receptor antagonist (IL-1ra) during cardiac surgery. METHOD Serum levels of cytokines and IL-1ra were measured in 10 patients during cardiac surgery with cardiopulmonary bypass. Six blood samples were drawn after inducing anaesthesia. In each sample, serum IL-10, IL-4, IL-8, IL-6 and IL-1ra were measured by enzyme linked immunosorbent assay. RESULTS Serum IL-6 and IL-8 concentration (19.1 +/- 8.8 pg.ml-1, and 13.4 +/- 5.2 pg.ml-1, preoperatively) increased to 227.5 +/- 191 pg.ml-1 and 81.0 +/- 56 pg.ml-1 at 60 min after declamping aorta (P < 0.01, respectively). Serum IL-10 concentration increased at 60 min after declamping the aorta compared with the preoperative value (from 1.0 +/- 0 pg.ml-1 to 552.0 +/- 158 pg.ml-1 P < 0.001]). Similarly, serum IL-1ra concentration increased from the preoperative value of 1331 +/- 896 pg.ml-1 to 43353 +/- 12812 pg.ml-1 at 60 min after declamping the aorta (P < 0.001). Positive correlations were obtained between IL-10 and IL-8, and between IL-10 and IL-6 (gamma = 0.7, gamma = 0.8, P < 0.001, respectively). CONCLUSION These findings demonstrate that pro- and anti-inflammatory cytokines increase to maintain their balance during cardiac surgery.