Open-heart surgery increases cerebrospinal fluid levels of Alzheimer-associated amyloid β

• Published in: Acta anaesthesiologica Scandinavica 2013-01, Vol.57 (1), p.82-88
• Main Authors: REINSFELT, B., WESTERLIND, A., BLENNOW, K., ZETTERBERG, H., RICKSTEN, S.-E.
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer Disease - cerebrospinal fluid; Amyloid beta-Peptides - cerebrospinal fluid; Amyloid beta-Protein Precursor - cerebrospinal fluid; Anestesi och intensivvård; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology and Intensive Care; Biological and medical sciences; Cardiac Surgical Procedures - adverse effects; Cardiopulmonary Bypass - adverse effects; Cytokines - cerebrospinal fluid; Encephalitis - cerebrospinal fluid; Encephalitis - etiology; Female; Humans; Male; Medical sciences
• ISSN: 0001-5172; 1399-6576; 1399-6576
• DOI: 10.1111/j.1399-6576.2012.02769.x

Background Neurocognitive dysfunction occurs frequently after open‐heart surgery. It has been suggested that cognitive decline after cardiac surgery with cardiopulmonary bypass (CPB) could be a functional consequence of Alzheimer's disease (AD)‐like neuropathological changes. The aim of the present study was to evaluate the cerebrospinal fluid (CSF) levels of amyloid β peptide (Aβ1–42) and soluble fragments of amyloid precursor protein (sAPP) as well as the cerebral inflammatory response to open‐heart surgery. Methods Ten patients undergoing aortic valve replacement with CPB were included. CSF was obtained the day before and 24 h after surgery for assessment of CSF levels of Aβ1–42 α‐cleaved sAPP and β‐cleaved sAPP (sAPP‐β). Furthermore, CSF and serum levels of the inflammatory cytokines: tumour necrosis factor alpha (TNF‐α), interleukin‐6 (IL‐6) and interleukin‐8 (IL‐8) were also assessed. Results Cardiac surgery with CPB increased CSF levels of Aβ1–42 from 447 ± 92 to 641 ± 83 ng/l (P = 0.011), while CSF levels of sAPP‐β decreased from 276 ± 35 to 192 ± 21 ng/ml (P = 0.031). CSF levels of TNF‐α increased from ≤ 0.60 to 0.79 ± 0.26 ng/l (P = 0.043), IL‐6 from 1.89 ± 0.53 to 22.8 ± 6.9 ng/l (P = 0.003) and IL‐8 from 39.8 ± 7.8 to 139 ± 18.3 ng/l (P