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Modulation of the cellular and humoral immune response to pediatric open heart surgery by methylprednisolone†

  1. Jozsef Bocsi1,
  2. Marie-Christin Hänzka1,
  3. Pavel Osmancik2,
  4. Jörg Hambsch1,
  5. Ingo Dähnert1,
  6. Ulrich Sack3,
  7. Wilfried Bellinghausen4,
  8. Peter Schneider1,
  9. Jan Janoušek1,
  10. Martin Kostelka5,
  11. Attila Tárnok1,*

Article first published online: 4 MAR 2011

DOI: 10.1002/cyto.b.20587

Issue

Cytometry Part B: Clinical Cytometry

Cytometry Part B: Clinical Cytometry

Volume 80B, Issue 4, pages 212–220, July/August 2011

Additional Information

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

Author Information

  1. 1

    Department of Pediatric Cardiology, Heart Centre, University of Leipzig, Leipzig, Germany

  2. 2

    Cardiocenter, Department of Cardiology, 3rd Medical School, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic

  3. 3

    Institute for Clinical Immunology, IKIT, University Leipzig, Leipzig, Germany

  4. 4

    Department of Anesthesiology, Heart Centre, University Leipzig, Leipzig, Germany

  5. 5

    Department of Cardiac Surgery, Heart Centre, University Leipzig, Leipzig, Germany

*Department of Pediatric Cardiology, Heart Centre, University of Leipzig, Strümpellstr. 39, D-04289 Leipzig, Germany

  1. †

    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.

Publication History

  1. Issue published online: 20 JUN 2011
  2. Article first published online: 4 MAR 2011
  3. Accepted manuscript online: 13 JAN 2011 01:13PM EST
  4. Manuscript Accepted: 3 JAN 2011
  5. Manuscript Revised: 14 DEC 2010
  6. Manuscript Received: 28 JUL 2010

Funded by

  • 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

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Keywords:

  • pediatric cardiac surgery;
  • congenital heart defects;
  • cardiopulmonary bypass;
  • immune response;
  • methylprednisolone

Abstract

Background:

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).

Methods:

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.

Results:

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.

Conclusions:

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

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