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Brain stem death induces pro-inflammatory cytokine production and cardiac dysfunction in sheep model
- Source :
- Biomedical Journal. 45:776-787
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- INTRODUCTION: Organs procured following brain stem death (BSD) are the main source of organ grafts for transplantation. However, BSD is associated with inflammatory responses that may damage the organ and affect both the quantity and quality of organs available for transplant. Therefore, we aimed to investigate plasma and bronchoalveolar lavage (BAL) pro-inflammatory cytokine profiles and cardiovascular physiology in a clinically relevant 6-hour ovine model of BSD. METHODS: Twelve healthy female sheep (37‒42 Kg) were anaesthetized and mechanically ventilated prior to undergoing BSD induction and then monitored for 6 hours. Plasma and BAL endothelin-1 and cytokines (IL-1β, 6, 8 and tumour necrosis factor alpha (TNF-α)) were assessed by ELISA. Differential white blood cell counts were performed. Cardiac function during BSD was also examined using echocardiography, and cardiac biomarkers (A-type natriuretic peptide and troponin I were measured in plasma. RESULTS: Plasma concentrations big ET-1, IL-6, IL-8, TNF-α and BAL IL-8 were significantly (p < 0.01) increased over baseline at 6 hours post-BSD. Increased numbers of neutrophils were observed in the whole blood (3.1×109 cells/L [95% confidence interval (CI) 2.06 - 4.14] vs. 6×109 cells/L [95%CI 3.92 - 7.97]; p < 0.01) and BAL (4.5×109 cells/L [95%CI 0.41 - 9.41] vs. 26 [95%CI 12.29 - 39.80]; p=0.03) after 6 hours of BSD induction vs baseline. A significant increase in ANP production (20.28 pM [95%CI 16.18 - 24.37] vs. 78.68 pM [95%CI 53.16 - 104.21];p < 0.0001) and cTnI release (0.039 ng/mL vs. 4.26 [95%CI 2.69 - 5.83] ng/mL; p < 0.0001), associated with a significant reduction in heart contractile function, were observed between baseline and 6 hours. CONCLUSIONS: BSD induced systemic pro-inflammatory responses, characterized by increased neutrophil infiltration and cytokine production in the circulation and BAL fluid, and associated with reduced heart contractile function in ovine model of BSD.
- Subjects :
- Cardiac function curve
medicine.medical_specialty
Heart Diseases
medicine.drug_class
medicine.medical_treatment
Inflammation
White blood cell
Internal medicine
medicine
Natriuretic peptide
Animals
Whole blood
Sheep
medicine.diagnostic_test
Tumor Necrosis Factor-alpha
business.industry
Interleukin-8
General Medicine
Transplantation
Bronchoalveolar lavage
Cytokine
medicine.anatomical_structure
Endocrinology
Cytokines
Female
medicine.symptom
business
Brain Stem
Subjects
Details
- ISSN :
- 23194170
- Volume :
- 45
- Database :
- OpenAIRE
- Journal :
- Biomedical Journal
- Accession number :
- edsair.doi.dedup.....5100e38e9421a093e90787123a5bfddd