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 cause 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 the 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-1O 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.