Congenital Heart Disease Ups Endotoxemia Risk in Children

Higher levels of intestinal fatty acid binding protein, endotoxin with congenital heart disease

WEDNESDAY, Sept. 14 (HealthDay News) -- Children undergoing surgery for congenital heart disease are at an increased risk of intestinal mucosal injury, endotoxemia, and activation of endotoxin signaling pathways that are associated with adverse outcome, according to a study published online Aug. 25 in the American Journal of Respiratory and Critical Care Medicine.

Nazima Pathan, Ph.D., M.R.C.P.C.H., from the Royal Brompton Hospital in London, and colleagues investigated the role of intestinal injury and endotoxemia in the pathogenesis of organ dysfunction following surgery for children with congenital heart disease (median age, 11.17 months). A total of 61 children undergoing surgery for congenital heart disease were assessed for blood levels of intestinal fatty acid binding protein (IFABP) and endotoxin, and underwent global transcriptomic profiling and assays of monocyte endotoxin receptor expression.

The investigators found greater levels of IFABP and endotoxin in children with duct-dependent cardiac lesions. The severity of vital organ dysfunction and intensive care stay was correlated with endotoxemia. Activation of pathogen sensing, antigen processing, and immune suppressing pathways was found at the genomic level postoperatively, as was downregulation of pathogen sensing receptors on circulating immune cells.

"Children undergoing surgery for congenital heart disease are at increased risk of intestinal mucosal injury and endotoxemia," the authors write.

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