Variation of Perioperative Mitochondrial DNA Concentration after Cardiopulmonary Bypass_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

QINChao-yi , GUJun , QIANHong , SHIYing-kang ,  MENGWei

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

MENGWei, Email: meng_wei_1111@yahoo.com

Keywords：

Cardipulmonary bypsaa; Mitochondrial DNA; Inflammation

DOI：

10.7507/1007-4848.20150066

Video：

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Objective To analyze the variation of perioperative concentration of mitochondrial DNA (mtDNA) in circulation system after cardiac surgery with cardiopulmonary bypass (CPB). Methods Between July and December 2014, 40 continuous patients underwent aortic valve replacement (AVR) and mitral valve replacement (MVR) in Department of Cardiovascular Surgery, West China Hospital, Sichuan University, including 16 males and 14 females with their mean age of 48.7±11.0 years and mean body weight of 59.0±6.9 kg. Perioperative mtDNA concentrations of circulatory blood were tested at different time points:before general anesthesia (T1), 1 min before CPB (T2), reperfusion of the ascending aorta (T3), 6 h after operation (T4), 24 h after operation (T5), 48 h after operation (T6). Results All the surgeries were successfully performed without early death. Postoperative complications were low cardiac output syndrome in 3 cases and acute kidney failure in 1 cases. The concentration of mtDNA in circulation system rising gradually after CPB. The mtDNA concentration of T3, T4 and T5 were significantly higher than T1 (P < 0.05). The peak level was observed at T5 and the mtDNA concentration of T6 was still significantly higher than that of T1 (P < 0.05). Conclusion The concentration of mtDNA in circulation system was rising after CPB and peak level appeared at 24 h after CPB.

Citation： QINChao-yi, GUJun, QIANHong, SHIYing-kang, MENGWei. Variation of Perioperative Mitochondrial DNA Concentration after Cardiopulmonary Bypass. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 241-244. doi: 10.7507/1007-4848.20150066 Copy

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3.	Zhang Q, Raoof M, Chen Y, et al.Circulating mitochondrial DAMPs cause inflammatory responses to injury.Nature, 2010, 464(7285):104-107.
4.	Kiessling AH, Guo FW, Gokdemir Y, et al.The influence of selective pulmonary perfusion on the inflammatory response and clinical outcome of patients with chronic obstructive pulmonary disease undergoing cardiopulmonary bypass.Interact Cardiovasc Thorac Surg, 2014, 18(6):732-739.
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7.	Wang CT, Zhang L, Wu HW, et al.Doxycycline attenuates acute lung injury following cardiopulmonary bypass:involvement of matrix metalloproteinases.Int J Clin Exp Pathol, 2014, 7(11):7460-7468.
8.	Boehm J, Eichhorn S, Kornek M, et al.Apolipoprotein E genotype, TNF-alpha 308G/A and risk for cardiac surgery associated-acute kidney injury in Caucasians.Ren Fail, 2014, 36(2):237-243.
9.	Morgan CJ, Gill PJ, Lam S, et al.Peri-operative interventions, but not inflammatory mediators, increase risk of acute kidney injury after cardiac surgery:a prospective cohort study.Intensive Care Med, 2013, 39(5):934-941.
10.	McIlroy DJ, Bigland M, White AE, et al.Cell necrosis-independent sustained mitochondrial and nuclear DNA release following trauma surgery.J Trauma Acute Care Surg, 2015 Jan 19.[Epub ahead of print].
11.	Nakahira K, Kyung SY, Rogers AJ, et al.Circulating mitochondrial DNA in patients in the ICU as a marker of mortality:derivation and validation.PLoS Med, 2013, 10(12):e1001577.
12.	Kim HR, Won SJ, Fabian C, et al.Mitochondrial DNA aberrations and pathophysiological implications in hematopoietic diseases, chronic inflammatory diseases, and cancers.Ann Lab Med, 2015, 35(1):1-14.
13.	Escames G, Lopez LC, Garcia JA, et al.Mitochondrial DNA and inflammatory diseases.Human Genetics, 2012, 131(2):161-173.
14.	Ding Z, Liu S, Wang X, et al.Oxidant stress in mitochondrial DNA damage, autophagy and inflammation in atherosclerosis.Sci Rep, 2013, 3:1077.
15.	Liu X, Wu Y, Zhu J, et al.Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients.Eur j med res, 2014, 19:13.
16.	Cao Y, Yang T, Yu S, et al.Relationships of adiponectin with markers of systemic inflammation and insulin resistance in infants undergoing open cardiac surgery.Mediators Inflamm, 2013:187940.
17.	Liu KD, Altmann C, Smits G, et al.Serum interleukin-6 and interleukin-8 are early biomarkers of acute kidney injury and predict prolonged mechanical ventilation in children undergoing cardiac surgery:a case-control study.Crit Care, 2009, 13(4):R104.
18.	El Azab SR, Rosseel PM, de Lange JJ, et al.Dexamethasone decre-ases the pro-to anti-inflammatory cytokine ratio during cardiac surgery.Br J Anaesth, 2002, 88(4):496-501.
19.	Bartz RR, Fu P, Suliman HB, et al.Staphylococcus aureus sepsis induces early renal mitochondrial DNA repair and mitochondrial biogenesis in mice.PLoS One, 2014, 9(7):e100912.
20.	Yu EP, Bennett MR.Mitochondrial DNA damage and atheroscle-rosis.Trends Endocrinol Metab, 2014, 25(9):481-487.
21.	Verschoor CP, Loukov D, Naidoo A, et al.Circulating TNF and mitochondrial DNA are major determinants of neutrophil phenotype in the advanced-age, frail elderly.Mol Immunol, 2015, 65(1):148-156.
22.	Maiuri MC, Kroemer G.Essential role for oxidative phosphoryla-tion in cancer progression.Cell Metab, 2015, 21(1):11-12.
23.	Kim B, Lee H, Kawata K, et al.Exercise-mediated wall shear stress increases mitochondrial biogenesis in vascular endothelium.PLoS One, 2014, 9(11):e111409.
24.	Sun S, Sursal T, Adibnia Y, et al.Mitochondrial DAMPs increase endothelial permeability through neutrophil dependent and independent pathways.PLoS One, 2013, 8(3):e59989.
25.	Zhang JZ, Liu Z, Liu J, et al.Mitochondrial DNA induces inflammation and increases TLR9/NF-kappaB expression in lung tissue.Int J Mol Med, 2014, 33(4):817-824.

1. Kristeller JL, Jankowski A, Reinaker T.Role of corticosteroids during cardiopulmonary bypass.Hosp Pharm, 2014, 49(3):232-236.
2. Simmons JD, Lee YL, Mulekar S, et al.Elevated levels of plasma mitochondrial DNA DAMPs are linked to clinical outcome in severely injured human subjects.Ann Surg, 2013, 258(4):591-596.
3. Zhang Q, Raoof M, Chen Y, et al.Circulating mitochondrial DAMPs cause inflammatory responses to injury.Nature, 2010, 464(7285):104-107.
4. Kiessling AH, Guo FW, Gokdemir Y, et al.The influence of selective pulmonary perfusion on the inflammatory response and clinical outcome of patients with chronic obstructive pulmonary disease undergoing cardiopulmonary bypass.Interact Cardiovasc Thorac Surg, 2014, 18(6):732-739.
5. Halter J, Steinberg J, Fink G, et al.Evidence of systemic cytokine release in patients undergoing cardiopulmonary bypass.J Extra Corpor Technol, 2005, 37(3):272-277.
6. Mahle WT, Matthews E, Kanter KR, et al.Inflammatory response after neonatal cardiac surgery and its relationship to clinical outcomes.Ann Thorac Surg, 2014, 97(3):950-956.
7. Wang CT, Zhang L, Wu HW, et al.Doxycycline attenuates acute lung injury following cardiopulmonary bypass:involvement of matrix metalloproteinases.Int J Clin Exp Pathol, 2014, 7(11):7460-7468.
8. Boehm J, Eichhorn S, Kornek M, et al.Apolipoprotein E genotype, TNF-alpha 308G/A and risk for cardiac surgery associated-acute kidney injury in Caucasians.Ren Fail, 2014, 36(2):237-243.
9. Morgan CJ, Gill PJ, Lam S, et al.Peri-operative interventions, but not inflammatory mediators, increase risk of acute kidney injury after cardiac surgery:a prospective cohort study.Intensive Care Med, 2013, 39(5):934-941.
10. McIlroy DJ, Bigland M, White AE, et al.Cell necrosis-independent sustained mitochondrial and nuclear DNA release following trauma surgery.J Trauma Acute Care Surg, 2015 Jan 19.[Epub ahead of print].
11. Nakahira K, Kyung SY, Rogers AJ, et al.Circulating mitochondrial DNA in patients in the ICU as a marker of mortality:derivation and validation.PLoS Med, 2013, 10(12):e1001577.
12. Kim HR, Won SJ, Fabian C, et al.Mitochondrial DNA aberrations and pathophysiological implications in hematopoietic diseases, chronic inflammatory diseases, and cancers.Ann Lab Med, 2015, 35(1):1-14.
13. Escames G, Lopez LC, Garcia JA, et al.Mitochondrial DNA and inflammatory diseases.Human Genetics, 2012, 131(2):161-173.
14. Ding Z, Liu S, Wang X, et al.Oxidant stress in mitochondrial DNA damage, autophagy and inflammation in atherosclerosis.Sci Rep, 2013, 3:1077.
15. Liu X, Wu Y, Zhu J, et al.Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients.Eur j med res, 2014, 19:13.
16. Cao Y, Yang T, Yu S, et al.Relationships of adiponectin with markers of systemic inflammation and insulin resistance in infants undergoing open cardiac surgery.Mediators Inflamm, 2013:187940.
17. Liu KD, Altmann C, Smits G, et al.Serum interleukin-6 and interleukin-8 are early biomarkers of acute kidney injury and predict prolonged mechanical ventilation in children undergoing cardiac surgery:a case-control study.Crit Care, 2009, 13(4):R104.
18. El Azab SR, Rosseel PM, de Lange JJ, et al.Dexamethasone decre-ases the pro-to anti-inflammatory cytokine ratio during cardiac surgery.Br J Anaesth, 2002, 88(4):496-501.
19. Bartz RR, Fu P, Suliman HB, et al.Staphylococcus aureus sepsis induces early renal mitochondrial DNA repair and mitochondrial biogenesis in mice.PLoS One, 2014, 9(7):e100912.
20. Yu EP, Bennett MR.Mitochondrial DNA damage and atheroscle-rosis.Trends Endocrinol Metab, 2014, 25(9):481-487.
21. Verschoor CP, Loukov D, Naidoo A, et al.Circulating TNF and mitochondrial DNA are major determinants of neutrophil phenotype in the advanced-age, frail elderly.Mol Immunol, 2015, 65(1):148-156.
22. Maiuri MC, Kroemer G.Essential role for oxidative phosphoryla-tion in cancer progression.Cell Metab, 2015, 21(1):11-12.
23. Kim B, Lee H, Kawata K, et al.Exercise-mediated wall shear stress increases mitochondrial biogenesis in vascular endothelium.PLoS One, 2014, 9(11):e111409.
24. Sun S, Sursal T, Adibnia Y, et al.Mitochondrial DAMPs increase endothelial permeability through neutrophil dependent and independent pathways.PLoS One, 2013, 8(3):e59989.
25. Zhang JZ, Liu Z, Liu J, et al.Mitochondrial DNA induces inflammation and increases TLR9/NF-kappaB expression in lung tissue.Int J Mol Med, 2014, 33(4):817-824.

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