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Ann Thorac Surg 2006;81:2201
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Invited commentary

Thomas V. Bilfinger, MD, ScD

Department of Surgery, SUNY at Stony Brook, HSC T19 Rm80, Stony Brook, NY 11794

(Email: tbilfinger{at}notes.cc.sunysb.edu).

Hsing and colleagues [1] describe for the first time the kinetics of interleukins belonging to the interleukin (IL)-10 family in conjunction with cardiopulmonary bypass (CPB). There are at least five novel human IL-10 family molecules: IL-19, IL-20, IL-22, IL-24, and IL-26. Similar to IL-10, these are secreted {alpha}-helical proteins with 30% homology in amino-acid sequence and definite positions for cysteine. The encoding genes are located in two clusters: IL-19, 20, 24 on1q31-32; IL-22, 26 on 12q15. In contrast to IL-10 being expressed in monocytes, less in NK cells, B cells and T cells, IL-19 and IL-20 are preferentially expressed in monocytes, and IL-22 is restricted to T cells and NK cells. So far their function is poorly understood, but it seems to be rather pro-inflammatory in distinction to IL-10. Interleukins 19 and 20 are associated with psoriatric skin lesions, while IL-22 has been associated with the acute phase reaction and inflammation and also with neonatal death. No clinical effect of these cytokines after CPB is known so far. Their pro-inflammatory effect seems to be a downstream phenomenon occurring after TNF{alpha}, IL-6, and IL-8 induction. This report from healthy patients serves as a first baseline of "normal" behavior of the expression of these molecules after bypass surgery. As we know, a "normal" pattern of established pro-inflammatory and anti-inflammatory cytokines after CPB has been described. We still have great difficulty to detect abnormal patterns, particularly in advance of a clinical correlate. With this article we have to add three more molecules to the list of inflammatory markers.


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  1. Hsing C-H, Hsieh M-Y, Chen W-Y, et al. Induction of interleukin-19 and interleukin-22 after cardiac surgery with cardiopulmonary bypass. Ann Thorac Surg 2006;81:2196–2201..




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