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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2024, Número 1

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Cir Card Mex 2024; 9 (1)


Linfocitos T reguladores en la 'balanza inflamatoria'' como respuesta a la circulación extracorpórea en cirugía cardiaca. Una revisión narrativa

Rodríguez-Morales M, Díaz-Quiroz G, Aceves-Chimal JL, Flores-Calderón O, García-Ortegón MS, Jaime-Uribe A, Morales-Cruz M, Sánchez-Godínez MF, Matus-Yarce JC, Viscarra-León JF, Rodríguez-Delgado JE, Corona-Chávez CE, Polanco-Lozada JRD, Bustos-Alcazar RA, Xochitemol-Herrera H, Mata-Ortega JA, Serrano-González SP, Romero-Pérez DA, Torres-Álvarez MG, Sánchez-Becerril I, Cruz-Hernández S, Morán-Chaidez E

Idioma: Ingles.
Referencias bibliográficas: 136
Paginas: 10-29
Archivo PDF: 631.53 Kb.


RESUMEN

La Circulación Extracorpórea (CEC) ofrece el beneficio de mantener un campo quirúrgico exangüe que aporta un escenario quirúrgico apropiado para la realización del procedimiento intracardiaco, condición indispensable en prácticamente todas las cirugías de corazón. Desafortunadamente, este procedimiento desencadena una cascada inflamatoria debido al contacto de la sangre con las superficies de la CEC. Esta inflamación puede tener un impacto negativo en la recuperación del paciente. Los linfocitos T reguladores son un subtipo de linfocitos T que intervienen en la modulación de la respuesta inflamatoria, especialmente a través de la activación de un factor de transcripción denominado FOXP3 que participa como el principal regulador transcripcional de los linfocitos Tregs. En esta revisión se identificó que la comprensión de la interacción entre los linfocitos Tregs y la CEC ofrece la oportunidad de entender la fisiopatología involucrada en la activación y desarrollo de la inflamación en la cirugía cardíaca, que a pesar que la CEC ha generado un gran impacto en el desarrollo de la cirugía a corazón abierto hay un precio que pagar, asociado al fenómeno inflamatorio que desencadena y finalmente afectando la evolución posquirúrgica del paciente sometido a dicho procedimiento y adicionalmente se reconoce que la capacidad reguladora de inflamación de los linfocitos TregFoxP3 ofrece la oportunidad de desarrollar estrategias futuras que propicien su activación, preservación de su función durante la CEC mediante fármacos inmunomoduladores, como corticosteroides y agonistas de receptores adrenérgicos, para coadyuvar en la mejora de resultados de la cirugía cardiaca.


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