Activation of cytokines in CABG failure

Abstract

Coronary artery disease (CAD) is the most common cause of death in this century. Many interventions have been demonstrated that decrease the rate of mortality and morbidity of CAD, and amongst them is the coronary artery bypass graft (CABG) procedure. Activation of infl ammatory cytokines preoperatively and postoperatively is one of the main causes of CABG failure. Many factors during CABG, such as reperfusion injury, will stimulate infl ammatory cytokines (e.g., TNF-α[alpha], IL-6), chemokines (e.g., IL-8), the complement system (e.g., C5a), neutrophils, and macrophages. Exposure to high levels of the infl ammatory cytokines IL-1beta, IL-2, IL-6, IL-15, or IL-21 stimulates aggressive cytotoxic T cells. These cytokines are responsible for the intensity of the attack against the transplanted graft by the patient on the immune system.