Key result
Red blood cell transfusion during abdominal aortic aneurysm repair significantly increased the gene expression of IL-1 (fold change 2.3) at 24 hours post-transfusion.
Why the study?
Given the vital need of aortic aneurysm patients for blood transfusion and the potential for transfusion-related systemic inflammatory responses, the study evaluated gene expression changes of inflammatory cytokines in these patients.
Does blood transfusion alter the gene expression of inflammatory cytokines (IL-1, IL-6, TNF-α) in patients undergoing abdominal aortic aneurysm repair?
Observational (n=20)
No
Does blood transfusion alter the gene expression of inflammatory cytokines (IL-1, IL-6, TNF-α) in patients undergoing abdominal aortic aneurysm repair?
Effect estimate: Fold change 2.3
Absolute Event Rate: 2.3% vs 1%
p-value: p=0.0376
Blood transfusion during abdominal aortic aneurysm repair is associated with increased gene expression of inflammatory cytokines IL-1, IL-6, and TNF-α.
Background: An abdominal aortic aneurysm (AAA or triple A) is a localized enlargement of the aorta in the abdominal region, with a diameter of 3 cm or more and also 50% larger than normal. AAA is the most common form of aortic aneurysm, about 85% of which occur below the kidneys, at the level, or above the kidneys. In case of aortic rupture, the patient's mortality rate will be 85% to 90%. It is estimated that about 0.2% of blood recipients have a systemic inflammatory response. Considering the vital need of aortic aneurysm patients for blood transfusion, we evaluated the gene expression changes of inflammatory cytokines such as interleukin 1 and 6 (IL-1 and 6) and tumor necrosis factor α (TNF-α) in these patients before anesthesia, after anesthesia, at different intervals after transfusion until the patient's discharge time. Materials and methods: On the time intervals of before anesthesia, after anesthesia, and before blood transfusion in the operating room, 24 and 48 hours after blood transfusion (pact cells) in the ICU and surgery department, and at the time of discharge, gene expression sampling was performed. The samples were taken and the total RNA was extracted. To quantitatively measure the genes of transcription factors, Real-time PCR was performed. T-test was used to analyze the gene expression after calculating fold change. Results: IL-1 gene expression increased in 24 hours after blood transfusion (24 h)(P=0.0376) and discharge time (P=0.0301), after anesthesia (AA) (P=0.235), and 72 hours after blood transfusion (P=0.1667). IL-6 gene expression changes after blood transfusion showed increased expression 24 hours after blood transfusion(P=0.046), and at the time of discharge (P=0.0473). TNF-α gene expression increased after anesthesia (AA) (P=0.699), in 24 hours after blood transfusion (24 h) (P=0.0625), 72 hours after blood transfusion (P=0.0121), and discharge time (P=0.0141). Conclusion: These changes showed IL-1, IL-6, and TNF-α gene expression increased 24 h after transfusion and upon discharge.
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Chegini et al. (2023) conducted an observational in Abdominal aortic aneurysm (n=20). Red blood cell transfusion vs. Before surgery (baseline) was evaluated on IL-1 gene expression fold change at 24 hours after blood transfusion (Fold change 2.3, p=0.0376). Red blood cell transfusion during abdominal aortic aneurysm repair significantly increased the gene expression of IL-1 (fold change 2.3) at 24 hours post-transfusion.
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