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

Edgars Grins, Per Ederoth, Henrik Bjursten, Alain Dardashti, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J. Hansson, Eskil Elmér, Lars Algotsson, Nabin Manandhar Shrestha, Stefan Jovinge

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1985-1994
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume36
Issue number7
Early online date2021
DOIs
Publication statusPublished - 2022

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems
  • Surgery
  • Anesthesiology and Intensive Care

Free keywords

  • acute kidney injury
  • cardiac surgery
  • cyclosporine
  • cystatin C
  • cytokines, IL-6

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