INFLUENCE OF THE ACUTE INFLAMMATION AND ENDOTHELIAL DYSFUNCTION ON THE RETINAL VEIN OCCLUSION FORMATION AFTER CARDIO-SURGICAL INTERFERENCES WITH THE USE OF CARDIOPULMONARY BYPASS
Abstract
Acute inflammation and endothelial dysfunction (EDF) are typical pathological processes, which determine the development of retinal vein occlusion (RVO) during cardio-surgery with the use of cardiopulmonary bypass (CB), but the connection of seromarkers according to the terms of occlusion appearance remains undefined.
The aim – to determine the influence of the acute inflammation and EDF for RVO formation after cardio-surgical interferences with the use of CB according to the terms of occlusion appearance.
Material and methods. There were selected for the research the data of 137 eyes (126 patients, the main group) with RVO after the surgery with CB. The comparison group contains the data about examination of 86 eyes (43 patients), who had not any occlusion during all term of examination. The control group consisted of 10 eyes (5 patients) without occlusion, which were examined before surgery. An ophthalmologist 2, 7, 30, 60, 90 and 180 days after cardio-surgical interference, examined patients. The content of IL-6, IL-8 and VE-cadherin in blood serum was determined by immunoenzyme technique (Bender Medsystems, Austria). Statistical data processing was performed with the use of Statistica 10 program (StatSoft, Inc., USA), regression analysis – with the use of the program package GLZ.
Results. The conduction of cardio-surgeries with the use of CB caused an increase of the interleukins content in the early period (IL-6 on the 2nd and 7th days, and IL-8 up to 30 days), while the content of VE-cadherin (VE-C) was slightly increased during almost all period of monitoring. With the availability of RVO, the content of IL-6 during all terms of occlusion appearance was significantly higher, the content of IL-6 was up to 30 days, and the content of VE-C in a greater degree was after the 7th day.
The regression analysis showed that after 1-2 days RVO appearance was directly related with the content of IL-6 and IL-8 in the blood, on the 3rd and 7th days – only with the content of IL-8, on the 8th and 30th days – with the content of all markers, and then with the content of IL-6 and VE-C. The accuracy of the prediction of the presence or absence of RVO at the appropriate period according to the calculated regression model is at least 78 % (p <0.001), what proves the influence of markers on the development of RVO.
Conclusions. The undertaken study shows the meaning of the acute inflammation and EDF by appearance of RVO with the use of CB, what justifies the application of the preventive measures - at the early stages the restriction of activity of the inflammatory process, at the later stages – prevention of EDF development.Downloads
References
Rogers, S., McIntosh, R. L., Cheung, N., Lim, L., Wang, J. J., Mitchell, P. et. al. (2010). The Prevalence of Retinal Vein Occlusion: Pooled Data from Population Studies from the United States, Europe, Asia, and Australia. Ophthalmology, 117 (2), 313–319. doi: http://doi.org/10.1016/j.ophtha.2009.07.017
Ponto, K. A., Elbaz, H., Peto, T., Laubert-Reh, D., Binder, H., Wild, P. S. et. al. (2015). Prevalence and risk factors of retinal vein occlusion: the Gutenberg Health Study. Journal of Thrombosis and Haemostasis, 13 (7), 1254–1263. doi: http://doi.org/10.1111/jth.12982
Ceruti, P., Tosi, R., Marchini, G. (2007). Simultaneous Bilateral Retinal Detachment following Coronary Artery Bypass Graft: Case Report. European Journal of Ophthalmology, 17 (5), 860–863. doi: http://doi.org/10.1177/112067210701700530
Raphael, J., Moss, H. E., Roth, S. (2019). Perioperative Visual Loss in Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 33 (5), 1420–1429. doi: http://doi.org/10.1053/j.jvca.2018.11.035
Roth, S., Moss, H. E. (2018). Update on Perioperative Ischemic Optic Neuropathy Associated With Non-ophthalmic Surgery. Frontiers in Neurology, 9. doi: http://doi.org/10.3389/fneur.2018.00557
Nuttall, G. A., Garrity, J. A., Dearani, J. A., Abel, M. D., Schroeder, D. R., Mullany, C. J. (2001). Risk Factors for Ischemic Optic Neuropathy After Cardiopulmonary Bypass: A Matched Case/Control Study. Anesthesia & Analgesia, 93 (6), 1410–1416. doi: http://doi.org/10.1097/00000539-200112000-00012
Nenekidis, I., Pournaras, C. J., Tsironi, E., Tsilimingas, N. (2011). Vision impairment during cardiac surgery and extracorporeal circulation: current understanding and the need for further investigation. Acta Ophthalmologica, 90 (3), e168–e172. doi: http://doi.org/10.1111/j.1755-3768.2011.02317.x
Rykov, S. O., Venediktova, O. A. (2018). Retinal vascular occlusion after cardio-surgery interferences with the use of cardiopulmonary bypass. Archive of Ophthalmology of Ukraine, 2, 32–38.
Paunel-Görgülü, A., Wacker, M., El Aita, M., Hassan, S., Schlachtenberger, G., Deppe, A. et. al. (2017). cfDNA correlates with endothelial damage after cardiac surgery with prolonged cardiopulmonary bypass and amplifies NETosis in an intracellular TLR9-independent manner. Scientific Reports, 7 (1). doi: http://doi.org/10.1038/s41598-017-17561-1
Kowalik, M. M., Lango, R., Siondalski, P., Chmara, M., Brzeziński, M., Lewandowski, K. et. al. (2018). Clinical, biochemical and genetic risk factors for 30-day and 5-year mortality in 518 adult patients subjected to cardiopulmonary bypass during cardiac surgery – the INFLACOR study. Acta Biochimica Polonica, 65 (2), 241–250. doi: http://doi.org/10.18388/abp.2017_2361
Zhang, J., Jiang, Z., Bao, C., Mei, J., Zhu, J. (2016). Cardiopulmonary bypass increases pulmonary microvascular permeability through the Src kinase pathway: Involvement of caveolin-1 and vascular endothelial cadherin. Molecular Medicine Reports, 13 (3), 2918–2924. doi: http://doi.org/10.3892/mmr.2016.4831
Brettner, F., Chappell, D., Schwartz, L., Lukasz, A., Kümpers, P., Becker, B. F. et. al. (2017). Vascular Endothelial Dysfunction during Cardiac Surgery: On-Pump versus Off-Pump Coronary Surgery. European Surgical Research, 58 (5-6), 354–368. doi: http://doi.org/10.1159/000480431
Dejana, E., Orsenigo, F., Lampugnani, M. G. (2008). The role of adherens junctions and VE-cadherin in the control of vascular permeability. Journal of Cell Science, 121 (13), 2115–2122. doi: http://doi.org/10.1242/jcs.017897
Orsenigo, F., Giampietro, C., Ferrari, A., Corada, M., Galaup, A., Sigismund, S. et. al. (2012). Phosphorylation of VE-cadherin is modulated by haemodynamic forces and contributes to the regulation of vascular permeability in vivo. Nature Communications, 3 (1). doi: http://doi.org/10.1038/ncomms2199
Tsakiridis, K., Zarogoulidis, P., Vretzkakis, G., Mikroulis, D., Mpakas, A., Kesisis, G., Arikas, S. et. al. (2014). Effect of lornoxicam in lung inflammatory response syndrome after operations for cardiac surgery with cardiopulmonary bypass. Journal of Thoracic Disease, 6 (1), 7–20. doi: http://doi.org/10.3978/j.issn.2072-1439.2013.12.30
Warren, O. J., Smith, A. J., Alexiou, C., Rogers, P. L. B., Jawad, N., Vincent, C. et. al. (2009). The Inflammatory Response to Cardiopulmonary Bypass: Part 1—Mechanisms of Pathogenesis. Journal of Cardiothoracic and Vascular Anesthesia, 23 (2), 223–231. doi: http://doi.org/10.1053/j.jvca.2008.08.007
Jongman, R. M., Zijlstra, J. G., Kok, W. F., van Harten, A. E., Mariani, M. A., Moser, J. et. al. (2014). Off-Pump CABG Surgery Reduces Systemic Inflammation Compared With On-Pump Surgery but Does Not Change Systemic Endothelial Responses. Shock, 42 (2), 121–128. doi: http://doi.org/10.1097/shk.0000000000000190
Rossaint, J., Berger, C., Van Aken, H., Scheld, H. H., Zahn, P. K., Rukosujew, A., Zarbock, A. (2012). Cardiopulmonary Bypass during Cardiac Surgery Modulates Systemic Inflammation by Affecting Different Steps of the Leukocyte Recruitment Cascade. PLoS ONE, 7 (9), e45738. doi: http://doi.org/10.1371/journal.pone.0045738
Feng, J., Liu, Y., Singh, A. K., Ehsan, A., Sellke, N., Liang, J., Sellke, F. W. (2017). Effects of diabetes and cardiopulmonary bypass on expression of adherens junction proteins in human peripheral tissue. Surgery, 161 (3), 823–829. doi: http://doi.org/10.1016/j.surg.2016.08.057
Okutani, D., Lodyga, M., Han, B., Liu, M. (2006). Src protein tyrosine kinase family and acute inflammatory responses. American Journal of Physiology-Lung Cellular and Molecular Physiology, 291 (2), L129–L141. doi: http://doi.org/10.1152/ajplung.00261.2005
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