Influence of Immunoglobulin on Cellular Immune Function of Postoperative Infants with Cyanotic Congenital Heart Disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONGHai-long , HANJian-gang , GUjiang-rong , TAOShu-guang , YANGShi-hai , WENLin-lin ,  WANGJian-ming

Department of Cardiac Surgery, Children's Hospital of Hebei Province, Shijiazhuang 050031, P. R. China;

Corresponding author：

WANGJian-ming, Email: wang_li_w@yahoo.com

Keywords：

Congenital heart disease; Cyanosis; Immunoglobulin; Interleukin-4; Interferon gamma; Enzyme-linked immunosorbent assay

DOI：

10.7507/1007-4848.20140180

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Objective To investigate the influence of immunoglobulin (Ig)on celluar immune function of postoperative infants with cyanotic congenital heart disease (CCHD). Methods Forty infants who underwent surgical repair of CCHD in Department of Cardiac Surgery, Children's Hospital of Hebei Province from March to December 2012 were enrolled in this study. All the patients were randomly divided into 2 groups. Patients in Ig group received intravenous Ig treatment at the dosage of 1g/ (kg·day)for 2 days postoperatively in addition to routine therapy. Patients in the control group only received routine therapy without Ig treatment. Five ml venous blood samples of all the patients were taken preoperatively, 0.5 hour and 2 days postoperatively to examine serum levels of interferon gamma (IFN-γ)and interleukin-4 (IL-4)with double-antibody sandwich enzyme-linked immunosorbent assay (ELISA), which were compared between the 2 groups. Results There was no statistical difference in serum levels of IL-4 or IFN-γ preoperatively and at 0.5 hour postoperatively between the 2 groups (P > 0.05). Serum levels of IL-4 and IFN-γ at 0.5 hour postoperatively were significantly higher than preoperative levels in the 2 groups respectively (P=0.000). Serum IL-4 level of Ig group 2 days postoperatively was not statistically different from preoperative level (P=0.362), while serum IL-4 level of the control group 2 days postoperatively was significantly higher than preoperative level (P=0.006). Two days after the operation, serum levels of IL-4 and IFN-γ of Ig group were significantly lower than those of the control group respectively (P=0.039 and 0.007 respectively). Compared with serum levels at 0.5 hour postoperatively in the control group, serum IL-4 level at 2 days postoperatively decreased by 20.08% (P=0.001), and serum IFN-γ increased by 17.80% (P=0.001). Compared with serum levels at 0.5 hour postoperatively in Ig group, serum IL-4 level at 2 days postoperatively decreased by 35.38% (P=0.000), and serum IFN-γ only increased by 7.60% (P=0.143). Conclusion Cellular immune function disorder caused by the operation and cardiopulmonary bypass can be effectively improved by postoperative intravenous Ig administration, which may help to reduce postoperative complications.

Citation： SONGHai-long, HANJian-gang, GUjiang-rong, TAOShu-guang, YANGShi-hai, WENLin-lin, WANGJian-ming. Influence of Immunoglobulin on Cellular Immune Function of Postoperative Infants with Cyanotic Congenital Heart Disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 636-638. doi: 10.7507/1007-4848.20140180 Copy

1.	杨林海, 姚建宏, 苗翠萍.先天性心脏病免疫功能变化及其临床意义.山西医药杂志, 2001, 30(2):102-103.
2.	Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation:pathophysiology and treatment. An update. Eur J Cardiothorac Surg, 2002, 21(2):232-244.
3.	Asimakopoulos G. Systemic inflammation and cardiac surgery:an update. Perfusion, 2001, 16(5):353-360.
4.	Milot J, Perron J, Lacasse Y, et al. Incidence and predictors of ARDS after cardiac surgery. Chest, 2001, 119(3):884-888.
5.	Chello M, Mastroroberto P, Quirino A, et al. Inhibition of neutrophil apoptosis after coronary bypass operation with cardiopulmonary bypass. Ann Thorac Surg, 2002, 73(1):123-130.
6.	Giomarelli P, Scolletta S, Borrelli E, et al. Myocardial and lung injury after cardiopulmonary bypass:role of interleukin(IL)-10. Ann Thorac Surg, 2003, 76(1):117-123.
7.	Sablotzki A, Börgermann J, Baulig W, et al. Lipopolysaccharide-binding protein(LBP)and markers of acute-phase response in patients with multiple organ dysfunction syndrome(MODS)following open heart surgery. Thorac Cardiovasc Surg, 2001, 49(5):273-278.
8.	Fernando R, Chan R. Anti-inflammatory pre-treatment and the resul-tant effects of interleukin-10:adjuncts to multi-therapeutical strategies. Perfusion, 2000, 15(6):501-505.
9.	Johnson D, Mayers I. Multiple organ dysfunction syndrome:a narra-tive review. Can J Anaesth, 2001, 48(5):502-509.
10.	谢文剑. Th1/Th2细胞表面标志的研究进展.国外医学:流行病学传染病学分册, 2002, 29(5):305-307.
11.	Tārnok A, Schneider P. Induction of transient immune suppression and Thl/Th2 disbalance by pediatric cardiac surgery with cardiopulmonary bypass. Clin Appl Immunol Rev, 2001, 1(5):291-313.
12.	李庆生, 吴圣楣, 应大明, 等.静注免疫球蛋白对新生儿单个核细胞IL-2、IL-4 mRNA表达的调节.中华微生物学和免疫学杂志, 1998, 18(5):45-48.
13.	马洪美, 王亚利, 纪恩美, 等.病毒性心肌炎患儿T淋巴细胞亚群的变化.潍坊医学院学报, 2004, 26(1):37-38.
14.	姜萍, 王立杰, 王亚利, 等.静注免疫球蛋白对病毒性心肌炎患儿的心肌保护作用及疗效评价.潍坊医学院学报, 2004, 28(4):278-280.
15.	Zhu KY, Feferman T, Maiti PK, et al. Intravenous immunoglobulin suppresses experimental myasthenia gravis:Immunological mechanisms. J Neuroimmunol, 2006, 176(1-2):187-197.

1. 杨林海, 姚建宏, 苗翠萍.先天性心脏病免疫功能变化及其临床意义.山西医药杂志, 2001, 30(2):102-103.
2. Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation:pathophysiology and treatment. An update. Eur J Cardiothorac Surg, 2002, 21(2):232-244.
3. Asimakopoulos G. Systemic inflammation and cardiac surgery:an update. Perfusion, 2001, 16(5):353-360.
4. Milot J, Perron J, Lacasse Y, et al. Incidence and predictors of ARDS after cardiac surgery. Chest, 2001, 119(3):884-888.
5. Chello M, Mastroroberto P, Quirino A, et al. Inhibition of neutrophil apoptosis after coronary bypass operation with cardiopulmonary bypass. Ann Thorac Surg, 2002, 73(1):123-130.
6. Giomarelli P, Scolletta S, Borrelli E, et al. Myocardial and lung injury after cardiopulmonary bypass:role of interleukin(IL)-10. Ann Thorac Surg, 2003, 76(1):117-123.
7. Sablotzki A, Börgermann J, Baulig W, et al. Lipopolysaccharide-binding protein(LBP)and markers of acute-phase response in patients with multiple organ dysfunction syndrome(MODS)following open heart surgery. Thorac Cardiovasc Surg, 2001, 49(5):273-278.
8. Fernando R, Chan R. Anti-inflammatory pre-treatment and the resul-tant effects of interleukin-10:adjuncts to multi-therapeutical strategies. Perfusion, 2000, 15(6):501-505.
9. Johnson D, Mayers I. Multiple organ dysfunction syndrome:a narra-tive review. Can J Anaesth, 2001, 48(5):502-509.
10. 谢文剑. Th1/Th2细胞表面标志的研究进展.国外医学:流行病学传染病学分册, 2002, 29(5):305-307.
11. Tārnok A, Schneider P. Induction of transient immune suppression and Thl/Th2 disbalance by pediatric cardiac surgery with cardiopulmonary bypass. Clin Appl Immunol Rev, 2001, 1(5):291-313.
12. 李庆生, 吴圣楣, 应大明, 等.静注免疫球蛋白对新生儿单个核细胞IL-2、IL-4 mRNA表达的调节.中华微生物学和免疫学杂志, 1998, 18(5):45-48.
13. 马洪美, 王亚利, 纪恩美, 等.病毒性心肌炎患儿T淋巴细胞亚群的变化.潍坊医学院学报, 2004, 26(1):37-38.
14. 姜萍, 王立杰, 王亚利, 等.静注免疫球蛋白对病毒性心肌炎患儿的心肌保护作用及疗效评价.潍坊医学院学报, 2004, 28(4):278-280.
15. Zhu KY, Feferman T, Maiti PK, et al. Intravenous immunoglobulin suppresses experimental myasthenia gravis:Immunological mechanisms. J Neuroimmunol, 2006, 176(1-2):187-197.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influence of Immunoglobulin on Cellular Immune Function of Postoperative Infants with Cyanotic Congenital Heart Disease

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