Cytokines as biomarkers of inflammatory response after open versus endovascular repair of abdominal aortic aneurysms: a systematic review

Abstract

The repair of an abdominal aortic aneurysm (AAA) is a high-risk surgical procedure related to hormonal and metabolic stress-related response with an ensuing activation of the inflammatory cascade. In contrast to open repair (OR), endovascular aortic aneurysm repair (EVAR) seems to decrease the postoperative stress by offering less extensive incisions, dissection, and tissue manipulation. However, these beneficial effects may be offset by the release of cytokines and arachidonic acid metabolites during intra-luminal manipulation of the thrombus using catheters in endovascular repair, resulting in systemic inflammatory response (SIR), which is clinically called post-implantation syndrome. In this systematic review we compared OR with EVAR in terms of the post-interventional inflammatory response resulting from alterations in the circulating cytokine levels. We sought to summarize all the latest evidence regarding post-implantation syndrome after EVAR. We searched Medline (PubMed), ClinicalTrials.gov and the Cochrane library for clinical studies reporting on the release of cytokines as part of the inflammatory response after both open/conventional and endovascular repair of the AAA. We identified 17 studies examining the cytokine levels after OR versus EVAR. OR seemed to be associated with a greater SIR than EVAR, as evidenced by the increased cytokine levels, particularly IL-6 and IL-8, whereas IL-1β, IL-10 and TNF-α showed conflicting results or no difference between the two groups. Polyester endografts appear to be positively correlated with the incidence of post-implantation syndrome after EVAR. Future large prospective studies are warranted to delineate the underlying mechanisms of the cytokine interaction in the post-surgical inflammatory response setting.

Red blood cell distribution width (RDW) is an independent predictor of post-implantation syndrome in patients undergoing endovascular aortic repair for abdominal aortic aneurysm

“…In agreement with the frequency earlier reported by others (14), 55 patients (i.e., 44%) developed PiS (mean period of onset, 1 day; IQR, 1 day), whilst revascularization failure only occurred in two patients (i.e., 1.6%). The main results of this study are shown in Table 1.…”

“…Nevertheless, some severe cases have also been described, in whom serious clinical signs develop, up to onset of severe systemic inflammatory response syndrome (SIRS) and multi-system organ failure (MOF), and who shall hence necessitate aggressive medical treatment and prolonged hospital stay (13). Several laboratory biomarkers have been measured in the attempt of timely predicting PiS, especially C reactive protein (CRP), interleukin (IL)-6 and IL-8, but none of these was found to have a satisfactory prognostic performance (14,15).…”

Effect of preoperative pregabalin on analgesia and interleukins after lumbotomy: prospective, randomized, comparative, double-blind study

“…Plasma concentrations of IL-6 are detectable in 60 minutes, peak between 4 and 6 hours and may persist for 10 days 11,19. IL-8 increases after 30–60 minutes, peak after 4 hours, and a progressive reduction in 24 hours 11,20. Peak of IL-10 is observed after 4–6 hours, returning to basal levels after 48 hours 12,21…”

“…Inflammatory ILs such as IL-6 and IL-8 are released during the trauma causing inflammation and pain 10,11. IL-10, which is anti-inflammatory, is also released by trauma 11,12…”

Circulating biomarkers for cardiovascular diseases: the beats never stop

“…Accordingly, this Special Issue of Acta Pharmacologica Sinica was planned to provide a forum for high quality original research and review articles to showcase the most recent advances in translational research and clinical practices on a wide-spectrum array of conventional as well as novel cardio-vascular biomarkers. Coverage of this Special Issue encompasses various forms of large or small molecules, such as proteins, peptides, cytokines, microRNAs, and metabolic by- This Special Issue covers a variety of pathological types of CVD, including acute myocardial infarction (AMI) [2][3][4][5] , heart failure [6] , aortic aneurysms [7,8] , carotid restenosis [9] , pulmonary arterial hypertension (PAH) [10] , and cardiac amyloidosis [11] . Several review articles provided in-depth analyses on the important diagnostic and prognostic roles of zinc [12] , oxylipins [13] , and leptin [14] in the fundamental cellular signaling and pathogenic processes in CVD and diabetes.…”