Efficacy of closed-circuit cardiopulmonary bypass system assessed by gene expression profiling

Research Project

Project/Area Number	25462143
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Cardiovascular surgery
Research Institution	Jichi Medical University
Principal Investigator	Yamaguchi Atsushi 自治医科大学, 医学部, 教授 (50265287)
Co-Investigator(Renkei-kenkyūsha)	KIMURA Naoyuki 自治医科大学, 医学部, 講師 (20382898) NAKAE Susumu 東京大学, 医科学研究所システム疾患モデル研究センター, 准教授 (60450409)
Research Collaborator	MATSUMOTO Kenji 国立成育医療研究センター研究所, 免疫アレルギー/感染研究部, 部長 (60181765) FUTAMURA Kyoko 国立成育医療研究センター研究所, 免疫アレルギー/感染研究部, 研究員 (60596956)
Project Period (FY)	2013-04-01 – 2016-03-31
Project Status	Completed (Fiscal Year 2015)
Budget Amount *help	¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000) Fiscal Year 2015: ¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000) Fiscal Year 2014: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000) Fiscal Year 2013: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Keywords	心臓手術 / 閉鎖型人工心肺回路 / 免疫応答 / 網羅的遺伝子解析
Outline of Final Research Achievements	Cardiopulmonary bypass (CPB) is known to cause systemic inflammatory reaction following cardiac surgery that can be associated with organ failure. In a standard “open”circuit system, blood makes contact to the air in the reservoir, which can trigger inflammatory response induced by oxidant stress. In the first series, we performed a randomized controlled study to compare the outcomes of heart valve surgery between open and closed circuit system (open circuit group, n=11, closed circuit group, n=10). There were no differences in the primary endpoints (open vs. closed, length of mechanical ventilation; 9.4 hours vs. 14.0 hours, P=0.21, length of ICU stay; 2.3 days vs. 2.4 days, P=0.87). In the second series, we conducted gene expression profiling of monocytes purified from post-CPB blood using DNA-microarray. Of note, multi-inflammatory mediators, including cytokins and chemokines related to neutrophil recruitment, were down-expressed in the closed circuit monocytes.