Correlação de marcadores inflamatórios com fatores prognósticos em transplantados cardíacos
DOI:
https://doi.org/10.34119/bjhrv7n9-303Keywords:
transplante cardíaco, marcadores inflamatórios, prognóstico no transplante cardíacoAbstract
Objetivo: Correlacionar a expressão das citocinas inflamatórias IL-1 β, TNF-α IL-6 e a contagem de macrófagos CD68 e neutrófilos CD66b no tecido da artéria pulmonar de transplantados cardíacos (TxC) com fatores de pior prognóstico. Métodos: Os níveis das interleucinas IL-6, IL-1β e TNF-α e de CD68 e neutrófilos CD66b, foram aferidos em fragmentos das artérias pulmonares de pacientes TxC com e sem fatores de mau prognóstico. Resultados: Não houve diferença estatisticamente significativa (p ≥ 0,05) entre os níveis dos marcadores inflamatórios aferidos nas artérias pulmonares dos TxC com ou sem fatores de mau prognóstico. Conclusão: Observamos que pacientes TxC, com fatores de pior prognóstico ou não, apresentaram níveis semelhantes de marcadores inflamatórios expressos nas artérias pulmonares. Tal fato sugere que o mau prognóstico no TxC está mais correlacionado com parâmetros clínicos propriamente ditos do que com a resposta inflamatória secundária a miocardiopatia associada.
References
Adamo, L., Rocha-Resende, C., Prabhu, S. D., & Mann, D. L. (2020). Reappraising the role of inflammation in heart failure. Nature Reviews Cardiology, 17(5), 269–285. https://doi.org/10.1038/s41569-019-0315-x
Afifi, S., Shayan, S., & Al-Qamari, A. (2009). Pulmonary Hypertension and Right Ventricular Function. International Anesthesiology Clinics, 47(1), 97–120. https://doi.org/10.1097/AIA.0b013e31819562ad
Bacal, F., Marcondes-Braga, F. G., Rohde, L. E. P., Xavier Júnior, J. L., Brito, F. de S., Moura, L. A. Z., Colafranceschi, A. S., Lavagnoli, C. F. R., Gelape, C. L., Almeida, D. R., Gaiotto, F. A., Atik, F. A., Figueira, F. A. M. S., Souza, G. E. C., Rodrigues, H., Campos, I. W., Souza Neto, J. D. de, Rossi Neto, J. M., Gasparetto, J., … Strabelli, T. M. (2018). 3a Diretriz Brasileira de Transplante Cardíaco. Arquivos Brasileiros de Cardiologia, 111(2), 230–289. https://doi.org/10.5935/abc.20180153
Barge-Caballero, E., Segovia-Cubero, J., Almenar-Bonet, L., Gonzalez-Vilchez, F., Villa-Arranz, A., Delgado-Jimenez, J., Lage-Galle, E., Perez-Villa, F., Lambert-Rodríguez, J. L., Manito-Lorite, N., Arizon-Del Prado, J. M., Brossa-Loidi, V., Pascual-Figal, D., Fuente-Galan, L. D. la, Sanz-Julve, M., Muñiz-Garcia, J., & Crespo-Leiro, M. (2013a). Preoperative INTERMACS Profiles Determine Postoperative Outcomes in Critically Ill Patients Undergoing Emergency Heart Transplantation. Circulation: Heart Failure, 6(4), 763–772. https://doi.org/10.1161/CIRCHEARTFAILURE.112.000237
Barge-Caballero, E., Segovia-Cubero, J., Almenar-Bonet, L., Gonzalez-Vilchez, F., Villa-Arranz, A., Delgado-Jimenez, J., Lage-Galle, E., Perez-Villa, F., Lambert-Rodríguez, J. L., Manito-Lorite, N., Arizon-Del Prado, J. M., Brossa-Loidi, V., Pascual-Figal, D., Fuente-Galan, L. D. la, Sanz-Julve, M., Muñiz-Garcia, J., & Crespo-Leiro, M. (2013b). Preoperative INTERMACS Profiles Determine Postoperative Outcomes in Critically Ill Patients Undergoing Emergency Heart Transplantation. Circulation: Heart Failure, 6(4), 763–772. https://doi.org/10.1161/CIRCHEARTFAILURE.112.000237
Busse, L. W., Barker, N., & Petersen, C. (2020). Vasoplegic syndrome following cardiothoracic surgery—review of pathophysiology and update of treatment options. Critical Care, 24(1), 36. https://doi.org/10.1186/s13054-020-2743-8
Carrillo-Salinas, F. J., Ngwenyama, N., Anastasiou, M., Kaur, K., & Alcaide, P. (2019). Heart Inflammation. The American Journal of Pathology, 189(8), 1482–1494. https://doi.org/10.1016/j.ajpath.2019.04.009
Deswal, A., Petersen, N. J., Feldman, A. M., Young, J. B., White, B. G., & Mann, D. L. (2001). Cytokines and Cytokine Receptors in Advanced Heart Failure. Circulation, 103(16), 2055–2059. https://doi.org/10.1161/01.CIR.103.16.2055
Elster, S. K., Braunwald, E., & Wood, H. F. (1956). A study of C-reactive protein in the serum of patients with congestive heart failure. American Heart Journal, 51(4), 533–541. https://doi.org/10.1016/0002-8703(56)90099-0
Funes, S. C., Rios, M., Escobar‐Vera, J., & Kalergis, A. M. (2018). Implications of macrophage polarization in autoimmunity. Immunology, 154(2), 186–195. https://doi.org/10.1111/imm.12910
Holness, C. L., & Simmons, D. L. (1993). Molecular cloning of CD68, a human macrophage marker related to lysosomal glycoproteins. Blood, 81(6), 1607–1613.
Levine, B., Kalman, J., Mayer, L., Fillit, H. M., & Packer, M. (1990). Elevated Circulating Levels of Tumor Necrosis Factor in Severe Chronic Heart Failure. New England Journal of Medicine, 323(4), 236–241. https://doi.org/10.1056/NEJM199007263230405
Liu, H., Yu, L., Yang, L., & Green, M. S. (2017). Vasoplegic syndrome: An update on perioperative considerations. Journal of Clinical Anesthesia, 40, 63–71. https://doi.org/10.1016/j.jclinane.2017.04.017
Maas, S. L., Soehnlein, O., & Viola, J. R. (2018). Organ-Specific Mechanisms of Transendothelial Neutrophil Migration in the Lung, Liver, Kidney, and Aorta. Frontiers in Immunology, 9. https://doi.org/10.3389/fimmu.2018.02739
Marra, A. M., Arcopinto, M., Salzano, A., Bobbio, E., Milano, S., Misiano, G., Ferrara, F., Vriz, O., Napoli, R., Triggiani, V., Perrone-Filardi, P., Saccà, F., Giallauria, F., Isidori, A. M., Vigorito, C., Bossone, E., & Cittadini, A. (2016). Detectable interleukin-9 plasma levels are associated with impaired cardiopulmonary functional capacity and all-cause mortality in patients with chronic heart failure. International Journal of Cardiology, 209, 114–117. https://doi.org/10.1016/j.ijcard.2016.02.017
Murphy, S. P., Kakkar, R., McCarthy, C. P., & Januzzi, J. L. (2020). Inflammation in Heart Failure. Journal of the American College of Cardiology, 75(11), 1324–1340. https://doi.org/10.1016/j.jacc.2020.01.014
Prausmüller, S., Spinka, G., Arfsten, H., Stasek, S., Rettl, R., Bartko, P. E., Goliasch, G., Strunk, G., Riebandt, J., Mascherbauer, J., Bonderman, D., Hengstenberg, C., Hülsmann, M., & Pavo, N. (2021). Relevance of Neutrophil Neprilysin in Heart Failure. Cells, 10(11), 2922. https://doi.org/10.3390/cells10112922
Prausmüller, S., Spinka, G., Stasek, S., Arfsten, H., Bartko, P. E., Goliasch, G., Hülsmann, M., & Pavo, N. (2022). Neutrophil Activation/Maturation Markers in Chronic Heart Failure with Reduced Ejection Fraction. Diagnostics, 12(2), 444. https://doi.org/10.3390/diagnostics12020444
Price, L. C., Wort, S. J., Perros, F., Dorfmüller, P., Huertas, A., Montani, D., Cohen-Kaminsky, S., & Humbert, M. (2012). Inflammation in Pulmonary Arterial Hypertension. Chest, 141(1), 210–221. https://doi.org/10.1378/chest.11-0793
Renlund, D. G., Taylor, D. O., Kfoury, A. G., & Shaddy, R. S. (1999). New UNOS rules: historical background and implications for transplantation management. United Network for Organ Sharing. The Journal of Heart and Lung Transplantation : The Official Publication of the International Society for Heart Transplantation, 18(11), 1065–1070. https://doi.org/10.1016/s1053-2498(99)00075-3
Rohde, L. E. P., Montera, M. W., Bocchi, E. A., Clausell, N. O., de Albuquerque, D. C., Rassi, S., Colafranceschi, A. S., de Freitas Junior, A. F., Ferraz, A. S., Biolo, A., Barretto, A. C. P., Ribeiro, A. L. P., Polanczyk, C. A., Gualandro, D. M., Almeida, D. R., da Silva, E. R. R., Figueiredo, E. L., Mesquita, E. T., Marcondes-Braga, F. G., … Martins, W. de A. (2018). Diretriz brasileira de insuficiência cardíaca crônica e aguda. Arquivos Brasileiros de Cardiologia, 111(3), 436–539. https://doi.org/10.5935/abc.20180190
Shaefi, S., Mittel, A., Klick, J., Evans, A., Ivascu, N. S., Gutsche, J., & Augoustides, J. G. T. (2018). Vasoplegia After Cardiovascular Procedures—Pathophysiology and Targeted Therapy. Journal of Cardiothoracic and Vascular Anesthesia, 32(2), 1013–1022. https://doi.org/10.1053/j.jvca.2017.10.032
Silvestre-Roig, C., Braster, Q., Ortega-Gomez, A., & Soehnlein, O. (2020). Neutrophils as regulators of cardiovascular inflammation. Nature Reviews Cardiology, 17(6), 327–340. https://doi.org/10.1038/s41569-019-0326-7
Soon, E., Holmes, A. M., Treacy, C. M., Doughty, N. J., Southgate, L., Machado, R. D., Trembath, R. C., Jennings, S., Barker, L., Nicklin, P., Walker, C., Budd, D. C., Pepke-Zaba, J., & Morrell, N. W. (2010). Elevated Levels of Inflammatory Cytokines Predict Survival in Idiopathic and Familial Pulmonary Arterial Hypertension. Circulation, 122(9), 920–927. https://doi.org/10.1161/CIRCULATIONAHA.109.933762
Stevenson, L. W., Pagani, F. D., Young, J. B., Jessup, M., Miller, L., Kormos, R. L., Naftel, D. C., Ulisney, K., Desvigne-Nickens, P., & Kirklin, J. K. (2009). INTERMACS Profiles of Advanced Heart Failure: The Current Picture. The Journal of Heart and Lung Transplantation, 28(6), 535–541. https://doi.org/10.1016/j.healun.2009.02.015
Swirski, F. K., & Nahrendorf, M. (2018). Cardioimmunology: the immune system in cardiac homeostasis and disease. Nature Reviews Immunology, 18(12), 733–744. https://doi.org/10.1038/s41577-018-0065-8
Thenappan, T., Goel, A., Marsboom, G., Fang, Y.-H., Toth, P. T., Zhang, H. J., Kajimoto, H., Hong, Z., Paul, J., Wietholt, C., Pogoriler, J., Piao, L., Rehman, J., & Archer, S. L. (2011). A Central Role for CD68(+) Macrophages in Hepatopulmonary Syndrome. American Journal of Respiratory and Critical Care Medicine, 183(8), 1080–1091. https://doi.org/10.1164/rccm.201008-1303OC
Tian, W., Jiang, X., Tamosiuniene, R., Sung, Y. K., Qian, J., Dhillon, G., Gera, L., Farkas, L., Rabinovitch, M., Zamanian, R. T., Inayathullah, M., Fridlib, M., Rajadas, J., Peters-Golden, M., Voelkel, N. F., & Nicolls, M. R. (2013). Blocking Macrophage Leukotriene B 4 Prevents Endothelial Injury and Reverses Pulmonary Hypertension. Science Translational Medicine, 5(200). https://doi.org/10.1126/scitranslmed.3006674
Tuder, R. M., Groves, B., Badesch, D. B., & Voelkel, N. F. (1994). Exuberant endothelial cell growth and elements of inflammation are present in plexiform lesions of pulmonary hypertension. The American Journal of Pathology, 144(2), 275–285.
Van Linthout, S., & Tschöpe, C. (2017). Inflammation – Cause or Consequence of Heart Failure or Both? Current Heart Failure Reports, 14(4), 251–265. https://doi.org/10.1007/s11897-017-0337-9
Vergadi, E., Chang, M. S., Lee, C., Liang, O. D., Liu, X., Fernandez-Gonzalez, A., Mitsialis, S. A., & Kourembanas, S. (2011). Early Macrophage Recruitment and Alternative Activation Are Critical for the Later Development of Hypoxia-Induced Pulmonary Hypertension. Circulation, 123(18), 1986–1995. https://doi.org/10.1161/CIRCULATIONAHA.110.978627
Vincent, J.-L., & De Backer, D. (2013). Circulatory Shock. New England Journal of Medicine, 369(18), 1726–1734. https://doi.org/10.1056/NEJMra1208943
Voelkel, N. F., Tuder, R. M., Bridges, J., & Arend, W. P. (1994). Interleukin-1 receptor antagonist treatment reduces pulmonary hypertension generated in rats by monocrotaline. American Journal of Respiratory Cell and Molecular Biology, 11(6), 664–675. https://doi.org/10.1165/ajrcmb.11.6.7946395
Wan, S., Marchant, A., DeSmet, J.-M., Antoine, M., Zhang, H., Vachiery, J.-L., Goldman, M., Vincent, J.-L., & LeClerc, J.-L. (1996). Human cytokine responses to cardiac transplantation and coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery, 111(2), 469–477. https://doi.org/10.1016/S0022-5223(96)70458-0
Weis, F., Kilger, E., Beiras‐Fernandez, A., Nassau, K., Reuter, D., Goetz, A., Lamm, P., Reindl, L., & Briegel, J. (2006). Association between vasopressor dependence and early outcome in patients after cardiac surgery. Anaesthesia, 61(10), 938–942. https://doi.org/10.1111/j.1365-2044.2006.04779.x


