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.	楊林海, 姚建宏, 苗翠萍.先天性心臟病免疫功能變化及其臨床意義.山西醫藥雜志, 2001, 30(2):102-103.
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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, B?rgermann 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.	謝文劍. Th1/Th2細胞表面標志的研究進展.國外醫學:流行病學傳染病學分冊, 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.	李慶生, 吳圣楣, 應大明, 等.靜注免疫球蛋白對新生兒單個核細胞IL-2、IL-4 mRNA表達的調節.中華微生物學和免疫學雜志, 1998, 18(5):45-48.
13.	馬洪美, 王亞利, 紀恩美, 等.病毒性心肌炎患兒T淋巴細胞亞群的變化.濰坊醫學院學報, 2004, 26(1):37-38.
14.	姜萍, 王立杰, 王亞利, 等.靜注免疫球蛋白對病毒性心肌炎患兒的心肌保護作用及療效評價.濰坊醫學院學報, 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. 楊林海, 姚建宏, 苗翠萍.先天性心臟病免疫功能變化及其臨床意義.山西醫藥雜志, 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, B?rgermann 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. 謝文劍. Th1/Th2細胞表面標志的研究進展.國外醫學:流行病學傳染病學分冊, 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. 李慶生, 吳圣楣, 應大明, 等.靜注免疫球蛋白對新生兒單個核細胞IL-2、IL-4 mRNA表達的調節.中華微生物學和免疫學雜志, 1998, 18(5):45-48.
13. 馬洪美, 王亞利, 紀恩美, 等.病毒性心肌炎患兒T淋巴細胞亞群的變化.濰坊醫學院學報, 2004, 26(1):37-38.
14. 姜萍, 王立杰, 王亞利, 等.靜注免疫球蛋白對病毒性心肌炎患兒的心肌保護作用及療效評價.濰坊醫學院學報, 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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