Open AccessPlasma prohepcidin as a negative acute phase reactant after large cardiac surgery with a deep hypothermic circulatory arrest
Author(s) -
P Maruna,
Jaroslav Lindner,
Jan Kunstýř,
Katerina M. Plocova,
Jaroslav A. Hubacek
Publication year - 2009
Publication title -
physiological research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 70
eISSN - 1802-9973
pISSN - 0862-8408
DOI - 10.33549/physiolres.931678
Subject(s) - cardiopulmonary bypass , deep hypothermic circulatory arrest , medicine , extracorporeal circulation , circulatory system , anesthesia , hematocrit , cardiac surgery , myocardial stunning , acute phase protein , cardiology , perfusion , inflammation , ischemia , cerebral perfusion pressure
Hepcidin is a key regulator of iron metabolism and a mediator ofanemia in inflammation. Recent in vitro studies recognizedprohepcidin as a type II acute phase protein regulating viainterleukin-6. The aim of the present study was to investigate thetime course of plasma prohepcidin after a large cardiac surgery inrelation to IL-6 and other inflammatory parameters. Patients withchronic thromboembolic hypertension (n=22, males/females14/8, age 51.9±10.2 years) underwent pulmonaryendarterectomy using cardiopulmonary bypass and deephypothermic circulatory arrest were included into study. Arterialconcentrations of prohepcidin, IL-1β, IL-6, IL-8, tumor necrosisfactor-α, and C-reactive protein were measured before/aftersternotomy, after circulatory arrest, after separation from bypass,and then 12, 18, 24, 36, 48 h and 72 h after the separation frombypass. Hemodynamic parameters, hematocrit and markers ofiron metabolism were followed up. Pulmonary endarterectomyinduced a 48 % fall in plasma prohepcidin; minimalconcentrations were detected after separation fromcardiopulmonary bypass. Prohepcidin decline correlated with anextracorporeal circulation time (p<0.01), while elevated IL-6levels were inversely associated with duration of prohepcidindecline. Postoperative prohepcidin did not correlate with markersof iron metabolism or hemoglobin concentrations within a 72-hperiod after separation from CPB. Prohepcidin showed itself as anegative acute phase reactant during systemic inflammatoryresponse syndrome associated with a cardiac surgery. Resultsindicate that the evolution of prohepcidin in postoperative periodimplies the antagonism of stimulatory effect of IL-6 andcontraregulatory factors inhibiting prohepcidin synthesis orincreasing prohepcidin clearance.