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Title: Substantial increases occur in serum activins and follistatin during lung transplantation.
Epworth Authors: Phillips, David
Other Authors: de Kretser, David
Bensley, Jonathan
Levvey, Bronwyn
Snell, Greg
Lin, Enjarn
Hedger, Mark
O'Hehir, Robyn
Keywords: Lung
Activin A
Activin B
Treatment Outcome
Internal Medicine Clinical Institute, Epworth HealthCare, Victoria, Australia
Epworth HealthCare, Victoria, Australia
Issue Date: Jan-2016
Publisher: San Francisco, CA : Public Library of Science
Abstract: BACKGROUND: Lung transplantation exposes the donated lung to a period of anoxia. Re-establishing the circulation after ischemia stimulates inflammation causing organ damage. Since our published data established that activin A is a key pro-inflammatory cytokine, we assessed the roles of activin A and B, and their binding protein, follistatin, in patients undergoing lung transplantation. METHODS: Sera from 46 patients participating in a published study of remote ischemia conditioning in lung transplantation were used. Serum activin A and B, follistatin and 11 other cytokines were measured in samples taken immediately after anaesthesia induction, after remote ischemia conditioning or sham treatment undertaken just prior to allograft reperfusion and during the subsequent 24 hours. RESULTS: Substantial increases in serum activin A, B and follistatin occurred after the baseline sample, taken before anaesthesia induction and peaked immediately after the remote ischemia conditioning/sham treatment. The levels remained elevated 15 minutes after lung transplantation declining thereafter reaching baseline 2 hours post-transplant. Activin B and follistatin concentrations were lower in patients receiving remote ischemia conditioning compared to sham treated patients but the magnitude of the decrease did not correlate with early transplant outcomes. CONCLUSIONS: We propose that the increases in the serum activin A, B and follistatin result from a combination of factors; the acute phase response, the reperfusion response and the use of heparin-based anti-coagulants.
DOI: 10.1371/journal.pone.0140948
PubMed URL:
ISSN: 1932-6203
Type: Journal Article
Affiliated Organisations: Research Development & Governance
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Internal Medicine

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