Effect of High-Dose Ulinastatin on the Cardiopulmonary Bypass-Induced Inflammatory Response in Patients Undergoing Open-Heart Surgery
Ulinastatin (UTI), a broad-spectrum elastase inhibitor, can stabilize lysosomal membranes and inhibit the activation and release of various inflammatory cytokines caused by cardiopulmonary bypass (CPB).[1,2] UTI has recently been considered to be an effective anti-inflammatory agent and has been widely used in clinical settings,[3–5] but the optimal dose has not been defined. Therefore, we conducted a prospective, randomized, controlled trial involving 60 patients undergoing cardiac surgeries with CPB and investigated the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8), at different time points in order to evaluate the anti-inflammatory efficacy of high-dose UTI and explore the optimum dose.
The results showed that the serum levels of the inflammatory cytokines increased postoperatively in all of the groups, indicating that the surgical procedure resulted in the activation of inflammatory cytokines. Comparisons among the groups showed that the postoperative inflammatory cytokine levels in U3 group were significantly lower than those in the other three groups, indicating that UTI can partially reduce the levels of inflammatory cytokines and inhibit the postoperative inflammation in a dose-dependent manner.
Therefore, different routes of UTI administration may restrict its effects. Further studies are needed to evaluate the most effective route of administering the total dose of UTI used in this study.
