NT-proBNP and the anti-inflammatory cytokines are correlated with endothelial progenitor cells’ response to cardiac surgery

Cesari, Francesca; Caporale, Roberto; Marcucci, Rossella; Caciolli, Sabina; Stefano, Pier Luigi; Capalbo, Andrea; Macchi, Claudio; Vannucci, Mauro; Gensini, Gian Franco; Abbate, Rosanna; Gori, Anna Maria

doi:10.1016/j.atherosclerosis.2007.09.045

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Volume 199, Issue 1 , Pages 138-146, July 2008

NT-proBNP and the anti-inflammatory cytokines are correlated with endothelial progenitor cells’ response to cardiac surgery

Francesca Cesari
- Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy
- Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Corresponding author at: Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy. Tel.: +39 055 7949420; fax: +39 055 7949418.
Roberto Caporale
- Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Rossella Marcucci
- Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy
- Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Sabina Caciolli
- Unit of Cardiac Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Pier Luigi Stefano
- Unit of Cardiac Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Andrea Capalbo
- Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy
- Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Claudio Macchi
- Centro S. Maria agli Ulivi, Fondazione Don Carlo Gnocchi Onlus IRCCS, Impruneta, Florence, Italy
Mauro Vannucci
- Unit Of Cardiologic Rehabilitation I.F.C.A. “Ulivella e Glicini”, Florence, Italy
Gian Franco Gensini
- Centro S. Maria agli Ulivi, Fondazione Don Carlo Gnocchi Onlus IRCCS, Impruneta, Florence, Italy
Rosanna Abbate
- Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy
- Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Anna Maria Gori
- Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy
- Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

Received 12 June 2007; received in revised form 19 September 2007; accepted 27 September 2007. published online 09 November 2007.

Abstract

Objective

We used cardiac surgery as a model of acute inflammatory response to evaluate the role of the inflammatory mediators in influencing the number of circulating endothelial progenitor cells (EPCs).

Methods

In 38 coronary artery by-pass grafting (CABG) [28M/10F] and in 54 valvular [28M/26F] patients the numbers of EPCs and the serum levels of IL-1ra, IL-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), high sensitivity C-reactive protein (hsCRP) and NT-proBNP were determined before (T1), 72h (T2), and 10 days after cardiac intervention (T3). Peripheral blood EPCs were measured by flow cytometric analysis and were defined as CD34+KDR+, CD133+KDR+ and CD34+CD133+KDR+.

Results

We demonstrate that the cardiac surgery reduces, 72h after intervention, the number of all the three types of EPCs with a contemporary marked increase of pro-inflammatory and anti-inflammatory cytokines and NT-proBNP levels. At baseline, EPC number was inversely related with age. At multiple linear regression analysis, after adjusting for age, cardiovascular risk factors and medications, age and IL-8 serum levels were significantly related to EPC number. At T2, an inverse relationship between NT-proBNP and the number of EPCs was found in the whole study population. At T3, 10 days after the intervention, at multivariate linear regression analysis, IL-10 and IL-1ra serum levels were significantly and positively associated with EPC number.

Conclusions

This study provides new insights into the relationship between inflammatory activation and mobilisation of EPCs in patients underwent cardiac surgery, by showing that NT-ProBNP and cytochemokines mediate the EPC changes in acute and post-acute response to the inflammatory stimulus of intervention.

Keywords: Endothelial progenitor cells, Cytochemokines, Cardiac surgery, N-terminal pro-brain natriuretic peptide