V prospektivní randomizované studii porovnat, sledováním určitých laboratorních ukazatelů, které monitorují zánětlivou reakci organismu, (uvedeny níže v popisu projektu), vliv standardního MO s vlivem mini-CPB na organismus nemocného, operovaného pro ICHS. Ověřit teoretický předpoklad lepší hemokompatibility mini-CPB systému u nemocných, operovaných pro ICHS. Ověřit teoretický předpoklad úspory krevních derivátů při použití mini-CPB systému u nemocných, operovaných pro ICHS. Současně studie umožní porovnat 2 metody vedení mimotělního oběhu a upravit protokol jejich klinického užití. Dle výsledků studie zavést metodiku použití mini-CPB do klinické praxe.; In prospective randomised trial to compare the systemic inflamatory response after the use od standard CPB circuit,mini-circuit and off pump surgery.Inflamatory markers (detailed see please part B) and other parameters will be studied in coronary pts. Toverify the theoretical advantages of mini-CPB concerning hemocompatibility in coronary patients To verify the clinical benefits of mini-CPB concerning of transfusion requirments To compare two methods of CPB conduction and document the clinical benefitof a minimized extracorporeal circulation concept.

• MeSH
• hrudní chirurgie MeSH
• kardiopulmonální bypass MeSH
• nekompatibilita krevních skupin MeSH
• podpůrné srdeční systémy MeSH
• reperfuzní poškození MeSH
• syndrom systémové zánětlivé reakce MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu IGA MZ ČR

AIMS: In a group of patients undergoing cardiac surgery performed both with ("on-pump") and without the use ("offpump") of cardiopulmonary bypass (CPB), we studied the changes of neutrophil membrane apoptosis-inducing complex Apo/Fas. METHODS: Expression of Apo/Fas (CD95) on leukocytes was evaluated by flow cytometry. RESULTS: In "on-pump" patients, we found an increase in the expression of CD95 median intensity fluorescence (MFI) on granulocytes from a baseline level median=56, (Q( 1)=45.5, Q(3)=64) to a median=88, (Q(1)=62, Q( 3)=109.5; p<0.01) at the 3(rd) postoperative day and median=74, (Q(1)=63, Q(3)=84.5; p<0.01) at the 7(th) postoperative day. In "off-pump" patients, granulocyte CD95 MFI was median=55, (Q(1)=51, Q(3)=84) before surgery. The significant increase was found on the 3(rd) postoperative day only; median=90, (Q( 1)=66; Q(3)=98; p<0.05). A similar pattern in the CD95 expression was also found if percentage changes of granulocyte CD95 MFI were followed. Moreover, the significantly increased Apo/Fas expression expressed as a percentage change of CD95 MFI was found in "on-pump" patients compared to "off-pump" patients, both at the 3(rd) postoperative day (p<0.05) and at the 7(th) postoperative day (p<0.01). CONCLUSIONS: This is the first direct evidence of increasing densities of the Apo/Fas complex on neutrophils in cardiac surgical patients.

• MeSH
• antigeny CD95 metabolismus   MeSH
• apoptóza imunologie   MeSH
• kardiochirurgické výkony MeSH
• kardiopulmonální bypass škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neutrofily cytologie   imunologie   metabolismus   MeSH
• pooperační komplikace imunologie   MeSH
• průtoková cytometrie MeSH
• senioři MeSH
• upregulace imunologie   MeSH
• zánět imunologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

CD163 is a member of scavenger receptor super family class B of the first subgroup. It is mapped to the region p13 on chromosome 12. Five different isoforms of CD163 have been described, which differ in the structure of their cytoplasmic domains and putative phosporylation sites. This scavenger receptor is selectively expressed on cells of monocytes and macrophages lineage exclusively. CD163 immunological function is essentially homeostatic. It also has other functions because participates in adhesion to endothelial cells, in tolerance induction and tissues regeneration. Other very important function of CD163 is the clearance of hemoglobin in its cell-free form and participation in anti-inflammation in its soluble form, exhibiting cytokine-like functions. We review the biological functions of CD163 which have been discovered until now. It seems apparent from this review that CD163 scavenger receptor can be used as biomarker in different diseases and as a valuable diagnostic parameter for prognosis of many diseases especially inflammatory disorders and sepsis.

• MeSH
• antigeny diferenciační myelomonocytární fyziologie   MeSH
• CD antigeny fyziologie   MeSH
• financování organizované MeSH
• lidé MeSH
• receptory buněčného povrchu fyziologie   MeSH
• scavengerové receptory fyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• přehledy MeSH

• Publikační typ
• abstrakty MeSH

Polymorphonuclear leukocytes or neutrophils are the main executors of cellular death, both in septic inflammation during bacterial infection and in sterile inflammation during trauma or surgery. Whereas in septic inflammation neutrophils perform a useful function to fortify the host's defense against infection, in sterile inflammation, by contrast, they contribute to unwelcome tissue damage. Regardless of the situation, activated neutrophils exhibit a prolonged lifespan and delayed apoptotic death which, under normal conditions, is a prerequisite for their natural renewal. Traditionally, delayed neutrophil apoptosis was considered to promote trauma or surgical injury. According to the results of recent studies, however surprising they may appear, the reverse might be in keeping with what happens IN VIVO. Apoptotic signaling in neutrophils could, by contrast, contribute to intrinsic protection of the host's tissues. This review article, aimed preferentially but not exclusively at the cardiac surgeon, presents some new information in support of this viewpoint, which fits in with our own observations.

• MeSH
• antigeny CD95 metabolismus   MeSH
• apoptóza MeSH
• ateroskleróza imunologie   patologie   MeSH
• bakteriální infekce imunologie   patologie   MeSH
• financování organizované MeSH
• kardiochirurgické výkony škodlivé účinky   MeSH
• lidé MeSH
• ligand Fas metabolismus   MeSH
• neutrofily imunologie   patologie   MeSH
• přirozená imunita MeSH
• protoonkogenní proteiny c-bcl-2 metabolismus   MeSH
• signální transdukce MeSH
• zánět imunologie   patologie   prevence a kontrola   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Current research is engaged in innovative technologies of extracorporeal circulation (ECC) systems in an effort to eliminate negative effects. Some studies have shown that, due to the complexity of technical settings of mini-ECC, they invoke a weaker immune response compared to classic ECC. The clinical benefits of using these systems have not been clearly proven yet. METHODS: A group of 54 patients who were indicated for elective coronary surgery were randomised into two groups - Group A (patients operated on using classic ECC - open modification) and Group B (patients operated on using mini-ECC). The concentrations of IL-6, PMN elastase and MCP-1 in both groups were monitored per- and postoperatively, along with the postoperative clinical course. RESULTS: The groups did not differ in the basic pre- and peroperative characteristics. We recorded a lower priming for mini-ECC (p < 0.001) and significantly reduced hemodilution during ECC. There were no differences in the clinical outcome in either group. Serum concentrations of monitored markers of immune reaction towards ECC showed higher activity during standard ECC. CONCLUSION: New technologies used in mini-systems have proven to lower activation of the immune system, which can be monitored using kinetics of proinflammatory mediators. In spite of these comparable laboratory results, we did not find differences in short-term clinical results when comparing both these groups of low-risk patients.

• MeSH
• chemokin CCL2 krev   MeSH
• interleukin-6 krev   MeSH
• koronární bypass metody   MeSH
• leukocytární elastasa krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mimotělní oběh MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

BACKGROUND: The scavenger receptor for complexes hemoglobin-haptoglobin (CD163), which is expressed on monocytes/ macrophages, is shed to the body fluids in a soluble form (sCD163). OBJECTIVES: To evaluate the dynamics of sCD163 in the blood of patients undergoing cardiac surgery. PATIENTS AND METHODS: Sixty-one adult patients who underwent coronary artery bypass grafting (CABG) were enrolled in the study. They were assigned to undergo CABG using either cardiopulmonary bypass (CPB), "on-pump", (22 patients), modified CPB, mini "on-pump", (17 patients) or without CPB, "off-pump", (22 patients) surgery. Serum levels of sCD163 in venous blood samples taken before and after surgery, and during an early postoperative period, were evaluated by Macro 163(TM) diagnostic kit (IQ Products, Groningen, NL). RESULTS: Compared to the preoperative levels ("on-pump"; 344 ng/mL, "off-pump"; 314.5 ng/mL, mini-invasive "on-pump"; 336.5 ng/mL) serum levels were elevated at the finish of surgery, reaching maximum at the 1(st) postoperative day ("onpump"; 658 ng/mL; p<0.05, "off-pump"; 810.5 ng/mL; p<0.01; mini-invasive "on-pump"; 663 ng/mL; non-significant).No significant differences regarding the serum levels of sCD163 between different surgical approaches were found. CONCLUSION: Serum level of sCD163 scavenger molecule for hemoglobin is elevated at the end of surgery and at the 1(st) postoperative day, being little influenced by cardiopulmonary bypass.

• MeSH
• antigeny diferenciační myelomonocytární krev   MeSH
• CD antigeny krev   MeSH
• haptoglobiny metabolismus   MeSH
• hemoglobiny metabolismus   MeSH
• kardiopulmonální bypass škodlivé účinky   MeSH
• koronární bypass škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• receptory buněčného povrchu krev   MeSH
• senioři MeSH
• zánět etiologie   krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

Background: Cardiac surgery provokes a systemic inflammatory response in any patient. This complex body reaction involves also RANK/RANKL molecules which have been recently identified as principal regulators of bone metabolism. Aims: To follow the changes in the expression of RANK/RANKL molecules on innate immune cells of cardiac surgical patients. Patients and Methods: Twenty-six patients undergoing cardiac surgical were assigned to undergo coronary artery bypass grafting using either cardiopulmonary bypass (“on-pump”) or modified “miniinvasive on-pump”. The expression of RANK/RANKL was performed by flow cytometry. Results: Significantly increased expression of RANK on monocytes of “miniinvasive on-pump” patients was found at the 1st, the 3nd, and 7th postoperative days. The similar pattern was found also for monocyte RANKL expression. In addition, RANKL expression was significantly increased at the 3rd postoperative day in “on-pump” patient. No significant differences between “miniinvasive on-pump” and “on-pump” cardiac surgical patients were found. Conclusion: The expression of both RANK and RANKL molecules is significantly enhanced on monocytes of “miniinvasive on-pump” cardiac surgical patients.

• MeSH
• financování organizované MeSH
• granulocyty metabolismus   MeSH
• kardiopulmonální bypass MeSH
• koronární bypass MeSH
• lidé MeSH
• ligand RANK metabolismus   MeSH
• monocyty metabolismus   MeSH
• protein RANK metabolismus   MeSH
• průtoková cytometrie MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

OBJECTIVE: Activation of innate immunity cells is inseparably linked to cardiac surgical operation. The aim of this study was to assess the kinetics in the expression of receptor for Fc part of IgG, FcgammaRI (CD64), and scavenger receptor CD163 on peripheral blood cells of cardiac surgical patients and to examine the effect of cardiac bypass as a separable influence on the systemic acute inflammatory response. METHODS: Forty patients, twenty in each group, were randomly assigned to CABG surgery performed either with "on-pump" or without "off-pump" cardiopulmonary bypass. Standardized quantitative flow cytometry method was used to determine the expression of surface markers. RESULTS: The density of CD64 molecule on monocytes reached maximum on the 1st postoperative day (P<.001) whereas the peak for CD64 molecule expression on granulocytes was postponed to the 3rd postoperative day (P<.001). The expression of CD163 scavenger molecule on monocytes reached maximum on the 1st postoperative day (P<.001). The density of CD163 molecule on monocytes on the 1st postoperative day is significantly higher in "on-pump" patients in comparison with "off-pump" patients (P<.001). CONCLUSION: In cardiac surgical patients the expression of activation marker FcgammaR1 (CD64) on monocytes is increased earlier in comparison with granulocytes in both "on-pump" and "off-pump" patients. The expression of scavenger molecule CD163 on monocytes is significantly higher in "on-pump" patients.

• MeSH
• antigeny diferenciační myelomonocytární krev   MeSH
• CD antigeny krev   MeSH
• financování organizované MeSH
• infuzní pumpy MeSH
• kardiopulmonální bypass metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• monocyty imunologie   MeSH
• nemoci srdce chirurgie   krev   MeSH
• průtoková cytometrie MeSH
• randomizované kontrolované studie jako téma MeSH
• receptory buněčného povrchu krev   MeSH
• receptory IgG krev   MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

• MeSH
• financování organizované MeSH
• Publikační typ
• abstrakty MeSH