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Effect of Cyclosporine on Cytokine Production in Elective Coronary Artery Bypass Grafting: A Sub-Analysis of the CiPRICS (Cyclosporine to Protect Renal Function in Cardiac Surgery) Study

Published:November 23, 2021DOI:https://doi.org/10.1053/j.jvca.2021.11.026

      Objectives

      The augmented inflammatory response to cardiac surgery is a recognized cause of postoperative acute kidney injury. The present study aimed to investigate the effects of preoperative cyclosporine treatment on cytokine production and delineate factors associated with postoperative kidney impairment.

      Design

      A randomized, double-blind, placebo-controlled, single-center study.

      Setting

      At a tertiary care, university hospital.

      Participants

      Patients eligible for elective coronary artery bypass grafting surgery; 67 patients were enrolled.

      Interventions

      Patients were randomized to receive 2.5 mg/kg cyclosporine or placebo before surgery. Cytokine levels were measured after the induction of anesthesia and 4 hours after the end of cardiopulmonary bypass.

      Measurements and Main Results

      Tissue-aggressive (interleukin [IL]-1β, macrophage inflammatory protein [MIP]-1β, granulocyte colony-stimulating factor [G-CSF], IL-6, IL-8, IL-17, MCP-1), as well tissue-lenient (IL-4) cytokines, were significantly elevated in response to surgery. Changes in cytokine levels were not affected by cyclosporine pretreatment.

      Conclusions

      Elective coronary artery bypass grafting surgery with cardiopulmonary bypass triggers cytokine activation. This activation was not impacted by preoperative cyclosporine treatment.

      Key Words

      Abbreviations:

      AKI (Acute Kidney Injury), ECC (Extracorporeal Circulation), CABG (Coronary Artery Bypass Grafting), mPTP (Mitochondrial Permeability Transition Pore), MAP (Mean Arterial Pressure)
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