Brain stem death induces pro-inflammatory cytokine production and cardiac dysfunction in sheep model

Walweel, K. and Boon, A.C. and See Hoe, L.E. and Obonyo, N.G. and Pedersen, S.E. and Diab, S.D. and Passmore, M.R. and Hyslop, K. and Colombo, S.M. and Bartnikowski, N.J. and Bouquet, M. and Wells, M.A. and Black, D.M. and Pimenta, L.P. and Stevenson, A.K. and Bisht, K. and Skeggs, K. and Marshall, L. and Prabhu, A. and James, L.N. and Platts, D.G. and Macdonald, P.S. and McGiffin, D.C. and Suen, J.Y. and Fraser, J.F. (2022) Brain stem death induces pro-inflammatory cytokine production and cardiac dysfunction in sheep model. Biomedical Journal, 45 (5). pp.776-787. ISSN 23194170

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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-h 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 h. 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 h 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 h 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 h. 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. © 2021 Chang Gung University

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Depositing User: Repository Administrator
Date Deposited: 03 Mar 2023 01:14
Last Modified: 03 Mar 2023 01:14

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