Objective: To compare the effects of aprotinin and tranexamic acid on blood cytokine secretion induced by the circulation of blood through an isolated extracorporeal circuit.
Design: Prospective, placebo-controlled study.
Setting: University hospital.
Participants: Healthy volunteers (n = 18).
Interventions: Blood (400 mL) first was drawn from volunteers, then circulated through an isolated extracorporeal circuit. Three groups were compared depending on the addition or not of an antifibrinolytic agent in the circuit (control group [n = 8], tranexamic group [n = 5], aprotinin group [n = 5]). Samples for measurement were taken before and at different time points after the start of circulation through the extracorporeal circuit. Cytokine (tumor necrosis factor-alpha, interleukin [IL]-6, IL-8, and IL-10) concentrations in the plasma and in the supernatant of lipopolysaccharide-stimulated whole blood cell cultures were analyzed.
Measurements and main results: In the control and tranexamic acid groups, tumor necrosis factor-alpha, IL-6, and IL-10 secretion by whole blood cell cultures were rapidly decreased, whereas IL-8 secretion was unaffected. In the aprotinin group, IL-8 secretion was also decreased (p < 0.05).
Conclusion: These results show that aprotinin, but not tranexamic acid, modulates the inflammatory response by reducing the IL-8 secretion of blood cells activated by contact with foreign surfaces.
Copyright 2002, Elsevier Science (USA). All rights reserved.