Alarmin HNPs 1-3 predicts theonset of lung injury after cardiac surgery in children (HUM1P.259)

Abstract Introduction:Human neutrophil peptides (HNPs) 1-3 are endogenous mediators to be characterized as alarmins. Methods:Children younger than 3 years after cardiac surgery were prospectively enrolled. Plasma concentrations of HNPs 1-3 and inflammatory cytokines were measured by ELISA during and after operation. Results: Thirty patients were enrolled which included 18 (60%) infants. Plasma HNPs 1-3 and the pro-inflammatory cytokine IL-6 levels significantly increased immediately after CPB (P < 0.001), while IL-8 increased 1 hour after operation (P = 0.002). The anti-inflammatory cytokine IL-10 levels immediately after CPB were also significantly elevated compared with baseline (P < 0.001). The multiple linear regression analysis showed that the plasma HNPs 1-3 levels immediately after CPB was independent correlated with declined lung function, as reflect by the PaO2/FiO2 ratio on the first 2 days after operation (for the first day: OR, -1.067, 95% CI, -0.548 to -1.574; P < 0.001; for the second day: OR, -0.667, 95% CI, -0.183 to -1.148; P = 0.009) and prolonged mechanical ventilation time (OR, -0.039, 95% CI, -0.005 to -0.056; P = 0.022). Plasma levels of HNPs 1-3, IL-8 and IL-10 returned to normal values, while IL-6 levels remained significantly higher than baseline 24 hours after operation (P < 0.001). Conclusions: Elevated HNPs 1-3 levels correlate with impaired lung function, and HNPs 1-3 is a useful early alarmin biomarker for lung injury inchildren after cardiac surgery.