Inflammatory Glycoprotein YKL-40 Is Elevated after Coronary Artery Bypass Surgery and Correlates with Leukocyte Chemotaxis and Myocardial Injury, a Pilot Study

Abstract

The aim of the present study was to investigate the levels of YKL-40 during and after coronary artery bypass grafting surgery (CABG) and to establish possible connections between YKL-40 and markers of oxidative stress, inflammation, and myocardial injury. Patients undergoing elective CABG utilizing cardiopulmonary bypass (CPB) were recruited into the study. Blood samples were collected at the onset of anesthesia, during surgery and post-operatively. Levels of YKL-40, 8-isoprostane, interleukin-8 (IL-8), monocyte chemotactic protein-1 (MCP-1) and troponin T (TnT) were measured by immunoassay. YKL-40 levels increased significantly 24 h after CPB. Positive correlation was seen between post-operative TnT and YKL-40 levels (r = 0.457, p = 0.016) and, interestingly, baseline YKL-40 predicted post-operative TnT increase (r = 0.374, p = 0.050). There was also a clear association between YKL-40 and the chemotactic factors MCP-1 (r = 0.440, p = 0.028) and IL-8 (r = 0.484, p = 0.011) linking YKL-40 to cardiac inflammation and fibrosis following CABG. The present results show, for the first time, that YKL-40 is associated with myocardial injury and leukocyte-activating factors following coronary artery bypass surgery. YKL-40 may be a factor and/or biomarker of myocardial inflammation and injury and subsequent fibrosis following heart surgery.

CD117+/CXCR4+ stem cell mobilization is associated to SDF1α, IL-6 and -8 in off-pump coronary revascularization open heart surgery

“…Our results showed that plasma IL-2 levels started to increase as soon as surgical trauma began and progressed thereafter but apparently it does not play a regulatory role in the mobilization of CD117 + cells; its increase is most probably secondary to its essential role in immune tolerance, generation of effector and memory cells and Treg cells development [39,40] and the need to minimize immunosuppression and immune cells dysfunction in any cardiac surgery procedure [41,42]. Interleukin 8 concentration peaked as the grafting procedure initiated; it has been clearly established that this leukocyte chemotactic cytokine is clearly associated with in ammation and brosis following coronary artery bypass surgery [43] as it recruits neutrophils into injured myocardium [44]. It is important to mention that interleukin 8 up regulates the expression of CXCR7 [45] and the latter plays a role in hematopoietic stem cells homing via SDF1a gradient as it is considered a mediator of the CXCR4/SDF1a axis [14].…”