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Critical Care

Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

Open Access

Induction of interleukin-10 during extracorporeal circulation

  • K Khalighi1,
  • C Weinstock2,
  • R Handgretinger3 and
  • G Ziemer1
Critical Care19993(Suppl 2):P13

Published: 2 March 1999


Humoral ImmunityOpen Heart OperationOpen HeartExtracorporeal CirculationTotal Leukocyte Count


The extracorporeal circulation (ECC) causes changes in cellular and cytokine pattern in addition to activation of complement system. These alterations result in a temporary depression of immunity and a perioperative susceptibility to infections. T lymphocytes required for both cell-mediated immune response and the production of antibody by B lymphocytes, are composed of two distinct subsets: Th1 and Th2 cells. Th1 cells produce IL-2 and interferon-γ and execute cell-mediated immune response; whereas Th2 cells produce IL-4, IL-5 and IL-10 and assist in antibody production for humoral immunity. While the influence of ECC in production and changes of several interleukins are known, it is still unclear if ECC induces IL-10 production and contribute to depression of immunity.

Material and methods

Twenty patients undergoing open heart operations without evidence of a concomitant malignant or immunologic disease; HIV and HBV seronegative were studied. EDTA-blood samples were drawn on six occasions. WBC was performed and FACS analysis enrolled. IL-10 was measured after cryopreservation of plasma by quantitative 'sandwich' enzyme immunoassay technique (sensitivity 1 pg/ml).


The total leukocyte count decreases at the institution of ECC (3521 ± 871) and remains nearly unchanged through the aortic clamping time (3503 ± 1370). After removal of aortic clamp a significant leucocytosis occurs (8085 ± 3571), through 3.POD (10708 ± 3606). The phasic changes of leukocytes is mainly caused by identical course of neutrophils. IL-10 shows a monophasic course with a peak concomitant to removal of aortic clamp (45.5 ± 49.6 pg/ml) and falls to preoperative levels at 3.POD (3.2 ± 4.5 pg/ml).


The increased level of IL-10 during the ECC indicates an activation of Th2 cells. IL-10 inhibits the production of IFN-γ, induces the differentiation of Th2 cells from uncommitted T cells. The inhibitory effect of IL-10 on Th1 cell differentiation causes a further depression of cell-mediated immunity during the early postoperative phase.

Authors’ Affiliations

Department of Thoracic & Cardiovascular Surgery, University of Tuebingen, Germany
Department of Transfusion Medicine, University of Tuebingen, Germany
Pediatric Hematology & Oncology, University of Tuebingen, Germany


© Current Science Ltd 1999