How to cite this article: Bocsi J, Hänzka M-C, Osmancik P, Hambsch J, Dähnert I, Sack U, Bellinghausen W, Schneider P, Janoušek J, Kostelka M, Tárnok A. Modulation of the cellular and humoral immune response to pediatric open heart surgery by methylprednisolone. Cytometry Part B 2011; 80B: 212–220.
Modulation of the cellular and humoral immune response to pediatric open heart surgery by methylprednisolone†
Article first published online: 4 MAR 2011
Copyright © 2011 International Clinical Cytometry Society
Cytometry Part B: Clinical Cytometry
Volume 80B, Issue 4, pages 212–220, July/August 2011
How to Cite
Bocsi, J., Hänzka, M.-C., Osmancik, P., Hambsch, J., Dähnert, I., Sack, U., Bellinghausen, W., Schneider, P., Janoušek, J., Kostelka, M. and Tárnok, A. (2011), Modulation of the cellular and humoral immune response to pediatric open heart surgery by methylprednisolone. Cytometry, 80B: 212–220. doi: 10.1002/cyto.b.20587
- Issue published online: 20 JUN 2011
- Article first published online: 4 MAR 2011
- Accepted manuscript online: 13 JAN 2011 01:13PM EST
- Manuscript Accepted: 3 JAN 2011
- Manuscript Revised: 14 DEC 2010
- Manuscript Received: 28 JUL 2010
- Deutsche Stiftung für Herzforschung, Frankfurt, Germany. Grant Number: MSM-0021620817
- Charles University research grant provided by the Ministry of Education, Youth and Physical Education of the Czech Republic. Grant Number: MSM 0021620817
- pediatric cardiac surgery;
- congenital heart defects;
- cardiopulmonary bypass;
- immune response;
With the intention to reduce overshooting immune response, glucocorticoids are frequently administered perioperatively in children undergoing open heart surgery. In a retrospective study we investigated extensively the modulation of the humoral and cellular immune response by methylprednisolone (MP).
This study was carried out on blood samples from two groups of children who had undergone surgical correction of atrial or ventricular septal defects, either without (MP−, n = 10), or with MP administration (MP+, n = 23, dose median 11 (IQR 10–16) mg kg−1 body weight) before cardiopulmonary bypass (CPB, duration median 42 (IQR 36–65) min). EDTA blood was obtained 24 h preoperatively, after anesthesia, at CPB begin and end, 4, 24, and 48 h after surgery, at discharge and at out-patient follow-up (median 8.2 (IQR 3.3–12.2) months after surgery). Complex blood analysis including clinical chemistry and flow cytometry were performed to monitor humoral immune response, differential blood count, lymphocyte subsets, and the degree of activation of various leukocyte subpopulations.
The patients' postoperative courses and follow-up were uneventful. Release of IL-6 and IL8 was reduced and that of the anti-inflammatory cytokine IL-10 upregulated by MP. Significant increase of circulating neutrophils and monocytes as inflammatory reaction to surgery and CPB contact was detected in both groups. However, invasion of monocytes to the periphery was delayed with MP. CD4+ and CD8+ T-lymphocyte counts were lower with MP treatment. B-lymphocyte count increased significantly after surgery in MP+ but remained constant in MP− group.
MP treatment partially decreased the pro-inflammatory effect of CPB surgery and induced anti-inflammatory effect on the cellular and humoral level. © 2011 International Clinical Cytometry Society