RCAAP Repository

Introduction: Leishmaniasis are illnesses caused by protozoan of the genus Leishmania, intracellular parasites of macrophages, that appears under diverse clinical forms. The cellular immune response is the effective protective response against these intracellular parasites. Lectins are capable to induce the production, by murine mononuclear cells, of interferon gamma (IFN - γ ), IL-12 and TNF-α, important molecules in an immune response for a Th1 profile, required to control this parasitism. O bjectives: To analyze the biological effect of the latex lectin of the Synadenium carinatum (ScLL), associate or not to the soluble Leishmania antigen (SLA), on the murine infection by L. (L.) amazonensis, evaluating its immunostimulating profile in cutaneous lesions and in infected macrophages. Materials and Methods: To evaluate the adjuvant potential of ScLL, groups of five mice had been immunized with different concentrations of this lectin associated or not to SLA. The infection of these animals was monitored weekly by measuring the infected paw during 10 weeks, when were evaluated the cellular and humoral immune responses through DTH and ELISA, respectively, as well as the expression of the IFN-γ, IL-4, IL-12, TNF-α and iNOS cytokines in the place of the lesion. The immunostimulating effect of ScLL was evaluated in culture of murine peritoneal macrophages stimulated with this lectin after 24, 48 and 72 hours of infection by L (L.) amazonensis, when the culture supernatants were harvested for the determination of NO and IL-12 production. The genic expression of cytokines as IL-1β, IL-12, TNF- α and iNOS and the intracellular parasitic load were analyzed 24, 48 and 72 hours after infection. Results: The ScLL lectin, in the concentration of 10 μg/ml was capable to stimulate the expression of IL-1β, TNF-α and iNOS cytokines, in vitro, as well as reducing in a significant way, the proliferation of parasites in the interior of macrophages. In vivo, this lectin was capable to protect the immunized mice partially, controlling the development of the lesion and inducing the expression of IFN-γ, IL-12, TNF-α and iNOS cytokines. High levels of IgG2a and low levels of IgG1 were detected in the serum of the immunized animals, being correlated with the control of the infection. Conclusions: The ScLL lectin conferred partial protection to the animals immunized after challenge with L. (L.) amazonensis, inducing a profile of immune response capable to control the parasitism in vivo e in vitro. Jointly, the data obtained with ScLL suggests that it can be used as adjuvant in experimental models of vaccination against L. (L.) amazonensis.

Canine Monocytic Ehrlichiosis (CME) is a disease with a extensive distribution in Brazil and the world. The etiologic agent is a gram negative obligate intracellular bacterium called Ehrlichia canis, which needs of the vector, Rhipicephalus sanguineus to infect the dog. In 2009 it was carried out the first isolation of this agent in Uberlandia from a sick dog. This isolate was propagated in vitro and the 16S rRNA gene was sequenced for characterization and comparison with other isolates. Sequencing of 16S rRNA confirmed the identification of the isolate as E. canis and showed high homology with other strains and isolates deposited in GenBank. We also evaluated the antigenicity in indirect immunofluorescence assay (IFA), using this antigen and other Brazilian isolate, called São Paulo, and canine sera from both cities. The results by IFA for sera of dogs from São Paulo and Uberlândia were concordant with antigens, despite the variation in the final title. By analyzing the Kappa coefficient, I was noted that the two antigens have different answers, being that the animals from São Paulo, who probably acquired antibodies against the strain isolated from that region, respond similarly to ehrlichia Uberlandia. However, the animals that probably came into contact with E. canis from Uberlândia produced antibodies with higher affinity for antigen Uberlândia. The São Paulo and Uberlândia isolated had different sensitivity to the diagnosis of E. canis by IFA, but not enough to generate false negatives or positives. The prevalence of the disease in canine populations from Uberlândia was tested using the IFA, as well as, probable factors that may influence its occurrence were evaluated. The prevalence of CME was high in Uberlandia, being that 211 (52.8%) dog sera were positive in 400 serum samples. The observation by the owner of the contact of the dogs with ticks did not significantly influenced the occurrence of CME (p = 0.419). There was a trend (p = 0.057) of males to be more positive than females. Dogs over one year old were more positive (56.3%, p = 0.002). Stray dogs were also more positive (68.8%) compared with dogs for donation (34.1%) and with owner (54.8%) (p = 0.002). The place of residence also influenced the positivity, being that the dogs from the districts (76.7%) have higher positivity than from the city (55.9%) and rural area (39.2%) (p = 0.0001). The differences between the localities can be explained by low economic income of the districts when compared with the city, resulting in smaller care of dogs. Uberlândia is endemic to CME, and dogs over one year old, wandering and living in cities with less economic development have a greater predisposition to E. canis infection.

Since the first MRSA(Methicillin resistant Staphylococcus aureus) report, this pathogen has spread in hospitals in different regions of the world and is currently regarded as the major nosocomial infections agent, causing benign infections, such as skin and soft tissue and serious, like pneumonia and sepsis. In early 80 s MRSA samples were isolated from community infections in individuals without the presence of risk factors (CA-MRSA - Community-acquired-Methicillin-resistant Staphylococcus aureus). During the last decade there was a CA-MRSA participation in hospital infections increase, especially in the U.S.. This study aimed to investigate CA-MRSA and HAMRSA (Hospital-acquired-Methicillin-resistant Staphylococcus aureus) samples in hospital and community infections, considering classical and molecular epidemiological aspects at the Hospital de Clinicas, Universidade Federal de Uberlândia (HC-UFU), from September 2006 to September 2008. S. aureus cultures were obtained from HCUFU laboratory, and those classified as non-multiresistant were tested for genotypic (Polimerase Chain Reaction, Pulsed Field Gel Electrophoresis e Multilocus Sequence Typing). In total, 206 MRSA samples were selected, with only 45 (21.8%) nonmultiresistant. After genotyping tests eight samples were identified as SCCmec (Staphylococcal Cassete Chromossome mec) IV, belonging to a single clone by PFGE technique, with six pulsotypes. Seven of them were ST (Sequence Typing) 5 (CC5) by MLST. Data indicate a low CA-MRSA prevalence (non MR - 21.8% SCCmecIV - 3.8%) then reported in the United States, isolated from patients with several kind of hospital infections and risk factors. Only one SCCmecIV sample, recovered from a child had community origin, corresponding to an otitis, also characterized as ST5 clone. SCCmecIV samples showed distinct resistance profile and susceptibility to trimethoprim-sulfamethoxazole in all of them. Evolution to death related to multidrug resistant organism infections and skin / soft tissue infection or hospitalization in pediatric units to non-multiresistant infection, were independent risk factors. Hospital mortality was 47.8% among multidrug-resistant MRSA and 26.6% among nonmultidrug- resistant samples. There were no deaths among patients infected with MRSA SCCmecIV. Epidemiological studies of different MRSA strains, in hospital or community, for the medical and hospital relevance, should be cause for public health services concern and additional investigations.

This study aimed to evaluate the clinical efficacy and systemic/mucosal antibody response changes after sublingual immunotherapy (SLIT) using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in mite-allergic children. One-hundred and two patients presenting allergic rhinitis with or without asthma were selected for a randomized double-blind, placebo-controlled trial and distributed into three groups: DPT (Dpt allergen extract, n=34), DPT+MRB (Dpt allergen plus mixed respiratory bacterial extracts, n=36), and Placebo (n=32). Clinical evaluation and immunological analyses were carried out before and after 12 and 18 months of treatment, including rhinitis/asthma symptom and medication scores, skin prick test (SPT) to Dpt extract, and measurements of Dpt, Der p 1, Der p 2 specific IgE, IgG4, and IgG1 in serum and specific IgA in saliva and nasal lavage fluid. Clinical results showed a significant decline in rhinitis/asthma symptom scores in all groups, but medication use decreased only in DPT group after 12 months. SPT results showed no significant changes and SLIT was generally safe, with no severe systemic reactions. SLIT using Dpt allergen alone induced increased serum IgG4 levels to Dpt, Der p 1 and Der p 2, and increased serum IgG1 and salivary IgA levels to Dpt and Der p 1. SLIT using DPT+MRB was able to decrease IgE levels to Der p 2, to increase salivary IgA levels to Der p 1, but had no changes on specific IgG4 and IgG1 levels. In conclusion, clinical improvement was observed both in the SLIT group and the control, but only active SLIT was able to modulate the mucosal/systemic antibody responses. These findings support the role of specific serum IgG4 and IgG1, in addition to salivary IgA, as probable blocking antibodies or biomarkers of tolerance that may be useful for monitoring the allergen specific immunotherapy.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Human neurocysticercosis (NC) is an important but neglected cause of epilepsy in developing countries where the parasite occurs. Expression of single-chain variable fragment (scFv) antibodies on the surface of bacteriophage is widely used to prepare antibodies with pre-defined specificities. A phage antibody library was selected against peptides displayed on phages coupled to beads and total saline extract of Taenia solium metacestodes immobilized on microtiter plate wells. After two rounds of selection 96 phage clones of each panning were selected, tested for scFv expression and specificity to each target. Specific clones were further analyzed by ELISA (Enzyme-linked immunosorbent assay), Dot-blot, sequencing and immunofluorescence. After selection, three clones were used for antigen capture to characterize its targets for future immunodiagnostic assays development. Total saline extract was fractionated on ion exchange resin diethylaminoethyl (DEAE), and fractions were tested by ELISA to detect sera IgG from: NC, other parasites and health controls (40 each). The fractions with best diagnostic parameters (sensitivity, specificity, area under curve and likelihood ratio, calculated by TG-ROC) were selected and subjected to antigen capture using each purified scFv clone. Each captured fraction was tested by ELISA to detect IgG in 30 serum samples from each group. In immunofluorescence tests, no fluorescence was observed in negative controls, and all clones showed a non-uniform staining profile, and their targets were elucidated through mass spectrometry. After ion exchange fractionation and ELISA tests, DEAE S2 fraction showed to be the best one and was used to capture new antigens. DEAE S2 showed 93.3% specificity. Among all clones, A4 and B6 captured antigens from saline extract and DEAE S2 fraction, respectively, with the best diagnostic parameters. In conclusion, antibody phage display technology is a potential approach for the study of antigen-antibody interactions, which can be used to further elucidate the biology of interaction on neurocysticercosis and to capture new antigens with potential applications in NC diagnosis and therapeutics.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Healthcare-associated infections (HAI) represent a major cause of morbidity, mortality and costs, principally those caused by bacteria resistant and multiresistant to antibiotics. The present study evaluates the epidemiology and pathogenesis of HAI in the Pediatric Intensive Care Unit (PICU), as well as in patients with infections caused by S. aureus in a tertiary-care teaching hospital, focusing on incidence rates and epidemiological indicators, density of use of antibiotics, risk factors for development of these infections and associated mortality to Methicillin-resistant Staphylococcus aureus (MRSA). The study included National Helathycare Safety Network (NHSN) surveillance (prospective, longitudinal) of patients in PICU of Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU), the samples were recovered from the microbiology laboratory of the hospital, and evaluation of risk factors was made through a case (patients with HAI) versus control (patients without infection) study, from August/2009 to August/2010. An individual form of surveillance, with epidemiological, clinical and microbiological data from patients with S. aureus infections was filed. We recovered 255 isolates of S. aureus obtained from 230 patients, identified by the microbiology laboratory of the HC-UFU, from January to December 2010. We conducted a case-control matched study to assess associated mortality rates by MRSA, considering only patients with bloodstream infection (BSI). The study was approved by the Research Ethics Committee of the University (no003/11). HAI were a significant cause of morbidity in patients in the PICU, with a rate of 26.7 nosocomial infections per 1000 patient-days. Sepsis (19.6/1000 patient-days) was the most common infection, and 44.1% of the patients with sepsis had primary sepsis, and the main source of these infection were CVC or unknown, while in the secondary sepsis, lung and urinary tract were more frequent sources (8.8% each). Univariate analysis of risk factors for HAI showed the following: use of CVC (p = 0.01), use of more than two antibiotics (p <0.001), length of stay (p <0.0001) and ASIS V score (p <0.001), the first two being independent for the development of HAIS. Among the 15 cases of bloodstream infections associated with CVC, 40.0% were related to the use of this device. The high density of antibiotic use was not related to a decrease in the incidence of HAI in the investigated period. The evaluation of S. aureus in the hospital showed that 29.8% was MRSA. The epidemiological indicators showed an infection rate of 40.5 per 1000 patientdays. Sepsis was the most common infection in the investigated period. The use of antibiotics was not related to increased incidence of nosocomial infection by MRSA/1000 patient-days. Analyzing the risk factors, only the prior use of antibiotics (p <0.001) was an independent factor for MRSA infection. The hospital mortality was significantly higher among patients who had MRSA infection. The associated mortality rate of patients with MRSA BSI was 50.0% (p = 0.0134). The rate of HAI in the pediatric ICU was high (22.0%), with the majority acquired in the unit and represented by the family of Enterobacteriaceae as main agents. Sepsis was the most common cause of HAI in both, PICU and S.aureus infections in the hospital, with significant association with invasive devices. Our data suggest that methicillin resistance may be related with increased associated mortality to the microorganism among patients who acquired nosocomial bloodstream infection by S.aureus.

Staphylococcus aureus is one of the most common pathogens in the cause of ventilator-associated pneumonia (VAP) and nasal colonization is the major risk factor for subsequent development of infection by this organism. The aim of this study was to analyze the epidemiology of VAP by S. aureus resistant (MRSA) or sensitive (MSSA) to methicillin in patients admitted to the adult Intensive Care Unit of Hospital de Clinicas of Federal University of Uberlandia in the period between September 2008 and August 2010. The VAPs were defined based on clinical and radiological criteria and microbiological count106UFC/mL in tracheal aspirate, and risk factors for MRSA colonization were determined from a study case versus control. The identification of S. aureus was performed by conventional microbiological tests, and the antimicrobial susceptibility profile was determined by a disk diffusion technique. The mecA gene was characterized by the technique of polymerase chain reaction (PCR) and clonal profile by pulsed-field gel electrophoresis (PFGE). Additionally, 85% (873 of 1037) of the patients admitted were evaluated for nasal colonization and isolates of the environment (air and surface), and the hands of health care personal were also isolated for analysis. In total, 475 mechanically ventilated patients were analyzed and of these 21 (4.4%) progressed to VAP by S. aureus. The incidence rates of VAP and VAP by S. aureus per 1000 patients/day were 15.6 and 1.9, respectively. The MRSA phenotype represented only 19% of the etiology of VAPs S. aureus, and all these were considered late. Among the patients investigated for nasal colonization, the frequency of S. aureus was 26.7%, with an incidence of the 21.6 per 1000 patients/day. The colonization was associated with an increased incidence of VAP by this microorganism in accordance with Pearson\'s correlation. The nasal colonization was statistically significant risk factor for the development of this infection regardless of phenotype. Although several risk factors were identified for MRSA colonization in univariate analysis, such as antibiotics, colonization time, admission diagnosis, and invasive procedures, only the use of tracheostomy was independently associated. The environmental contamination of surfaces with S. aureus was detected near the beds of patients infected or colonized at a frequency of 10.7%, showing a positive correlation. A similar frequency (8.2%) was also observed in the hands of health care personal. The temporal/spatial relationship was observed in about half (47.6%) of the patients with S. aureus. The results showed the presence of a variety of genotypes in the unit; of the 28 samples tested, 13 PFGE profile were found, 6 corresponded to MSSA, and 7 to MRSA. The same clonal profile was observed in samples corresponding to the same patient including colonization, infection, environment, and the hands of health care professionals. The incidence of PAVs S. aureus was low with a predominance of cases by MSSA and nasal colonization represented a risk factor for VAP evolution. There was participation of the environment as a reservoir secondary to MRSA infection and there was evidence of cross-transmission in unit.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Dermatophagoides farinae (Df) is considered one of the major house dust mite and it is an important source of indoor allergens worldwide. Several Df allergens occur as isoallergens that present changes in amino acid sequences or glycosylation, leading to differences in allergen sensitization. The aim of this study was investigate the reactivity of IgE, IgG1 and IgG4 antibodies to Df antigenic isoforms in Brazilian atopic and non-atopic subjects, with potential application for the allergy laboratorial diagnosis and follow-up of specific allergen immunotherapy. Atopic (n=60) and non-atopic (n=30) subjects were selected on the basis of the respiratory allergy history and skin prick test (SPT) to house dust mite allergens. Sera were analyzed by enzyme-linked immunosorbent assay (ELISA) for measuring levels of IgE, IgG1 and IgG4 antibodies to Df allergen. Crude Df extract was separated by one (1-D)- and two (2-D)-dimensional electrophoresis with subsequent 1-D and 2-D immunoblot for evaluating the profile of IgE-, IgG1-, and IgG4-binding components from the Df allergen extract in sera from atopics and non-atopics. Levels of IgE, IgG1 and IgG4 specific to Df and frequencies of 1-D reactivity profile were used to select sera to immunoproteomic analyses. 2-D IgE, IgG1 and IgG4 reactivity profile shown interestingly patterns of recognition and some spots could be related to hypothetical allergens. Single IgE and double IgE/IgG4 binding in atopic migrated only below 37 kDa and single IgG1 binding migrated exclusively above 37 kDa. The immunoproteomics approach in both atopic and non-atopic groups showed a great number of antigenic components and the most of them could be related to a known hypothetical allergen. In addition, the immunoreactivity of these proteins observed may be potentially useful for serodiagnosis and opens further opportunities for the development of a personalized immunotherapeuticalcomposition for treating patients with allergic disease.

The colonization of the oropharynx plays an important role in the pathogenesis of ventilator-associated pneumonia (VAP). The presence of multidrug-resistant (MDR) microorganisms and inappropriate empirical antimicrobial therapy negatively affects the evolution of this infection. This study evaluated the involvement of ORSA and OSSA phenotypes in the etiology of VAPs, the importance of previous colonization of the oropharyngeal mucosa in the pathogenesis, the influence of the use of antibiotics in the emergence of MDR samples, and prognosis of patients when empirical antimicrobial therapy was introduced. We conducted a longitudinal, prospective study with the search for cases of oropharygeal colonization and VAP by S. aureus form May 2009 to August 2010. Additionally, two case-control studies were also performed; the first to assess the risk factors associated with colonization by S. aureus resistant to oxacillin (ORSA), with cases represented by colonized patients by ORSA and controls those colonized by S. aureus sensitive to oxacillin (OSSA), and the second study to evaluate factors associated with the development of VAP by MDR microorganisms, with cases represented by patients with VAP by bacteria MDR and controls those with VAP by bacteria non-MDR. In total, 346 patients were submitted to mechanical ventilation, of which 36.4% were colonized in the oropharynx with S. aureus, corresponding to 63.5% and 36.5% of ORSA and OSSA, respectively and risk of pneumonia was significant for both phenotypes. The high density of use of glycopeptides (269.56 DDDs / 1,000 patient-days) was related to colonization by ORSA (Pearson r = 0.57 / P = 0.02), and age > 60, previous antibiotic therapy and previous use of carbapenems were independent risk factors for the presence of this bacteria in the mucosa of the oropharynx. The VAP rate was 25.3% with MDR microorganisms representing nearly half (47.3%). The risk factors for this latter group were: length of hospital stay, use of corticoids and prior use of antibiotics. Empirical antimicrobial therapy was inappropriate in 30.9% of patients with VAP and was significantly associated with 30- day ICU mortality, as well as the etiology by microorganisms MDR. In summary, there was a significant relationship between the colonization of the oropharyngeal mucosa and the risk of VAP by both phenotypes. The ORSA colonization was associated with age> 60 years and previous exposure to antibiotics, the latter also associated with VAP by microorganisms MDR, which had a worse prognosis, as well as those who received inappropriate empirical antimicrobial therapy. The importance of VAPs in ICUs of hospitals in developing countries with limited resources in healthcare hospital is clear, making it necessary more and better epidemiological studies, and research on strategies easier and less costly in its prevention.

The hantaviruses are among the most important zoonotic pathogens of humans, especially due to high fatality, those associated with Hantavirus Pulmonary Syndrome (HPS). In Brazil, more than 1600 cases of HPS have been confirmed since 1993, with a fatality rate of 40%. The viral genotypes associated with HPS in humans, as well as those present in wild rodents were investigated in an endemic area of the state of Minas Gerais in this study. Furthermore, the seroprevalence for hantaviruses, the karyotyping of rodent species captured and the population dynamics of these animals on the Cerrado vegetation types were also evaluated in an ecoepidemiological approach. The ELISA and / or RT-PCR were used to test sera from human cases of SPH and wild rodents and rodent lung fragments. In our study, six patients were evaluated, of these six (100%) were seroreactive in ELISA in six (100%) was possible to amplify viral genetic material and in five (83.3%) was possible sequencing. Were observed in all the viral genotype Araraquara (ARAV), but with the formation of two well-defined clusters. The case fatality rate was 50%. Regarding rodents, 258 specimens were captured. Nine taxa were identified to species level and seven in genus level, all belonging to the subfamily Sigmodontinae. Necromys lasiurus was the most abundant (70.2). We observed a greater diversity of rodents in a fitofisionomy called semi-deciduous dry forest (07 taxa in species level and four in genus level). The winter dry season was associated with the highest capture success (p <0.0001). There was a higher prevalence of pregnancy during the rainy season (p <0.0001). There was a prevalence of IgG antibodies against hantavirus of 1.6%, all specimens of N. lasiurus. Among the four seroreactive rodents, three (75%) was possible to amplify viral genetic material and two (50%) was possible sequencing. Only ARAV viral genotype was observed. Samples of rodents had higher phylogenetic identity with the genotype sequenced of the human sample of Uberlândia, Minas Gerais, where the rodents were also captured. Samples identified with ARAV analyzed in this study were distributed at a distance of approximately 400 kilometers. Despite the geographical distance, we observed a high phylogenetic identity between two samples 384 km distant from each other. The environmental and demographic changes that have occurred in recent decades in the study area affected the ecology of wild rodents and facilitated the occurrence of hantavirus infections in humans and the emergence of HPS in this region, mainly ARAV transmitted by N. lasiurus. The observation in this study only the genotype ARAV in specimens of N. lasiurus and humans, does not exclude the possibility of co-circulation of other viral genotypes in this area, beyond the possibility of the existence of other reservoirs of hantaviruses, including non-rodents.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Pediatric cardiac surgery with cardiopulmonary bypass (CPB) induces a complex inflammatory reaction of variable intensity that, in severe cases, may lead to multiple organ dysfunctions, resulting in considerable morbidity and mortality. Previous studies have demonstrated the involvement of cytokines with both pro-­inflammatory and anti-­ inflammatory profile in the inflammatory response in this group of patients, as well as its relationship to morbidity in the postoperative period. The present study aimed to delineate the kinetics of plasma concentrations of eight different cytokines, to determine the impact of blood transfusion on these kinetics and to evaluate the possible correlation of postoperative morbidity with these kinetics. This study evaluated a group of 19 children diagnosed with non-­cyanotic congenital heart disease with volume overload of left ventricle and increased pulmonary blood flow, classified as low risk for operative mortality, undergone corrective surgery with CPB. Blood samples were taken in seven different times: after induction of anesthesia but prior to initiation of surgery (T0), five minutes after CPB beginning (T1), five minutes after the opening of the aortic clamp (T2), at the end of surgical procedure (T3), four hours after the end of surgery (T4), at the first postoperative day (T5) and at the second postoperative day (T6). For each sample was carried out the measurement of plasma concentrations of interleukin (IL) -­2, interleukin (IL) -­4, interleukin (IL) -­6, interleukin (IL) -­‐10, interleukin (IL) -­17, tumor necrosis factor (TNF)-­α, interferon (IFN)-­γ and macrophage migration inhibitory factor (MIF). We also evaluated blood transfusion and eight morbidity related variables: CPB time, aortic cross-­clamping time, inotropic score, cumulative TISS score, oxygenation index, volume of postoperative bleeding in the first 48 hours, duration of mechanical ventilation and length of stay in intensive care unit (ICU) postoperatively. Considering the kinetics of the concentrations of the cytokines evaluated, the concentrations of IL-­6, IL-­10 and MIF significantly changed in response to the surgical procedure. The concentrations of IL-­‐6 increased in T3, T4 and T5 and returned to baseline values at T6. The concentrations of IL-­10 increased in T2, T3 and T4 and returned to baseline values at T5. Concentrations of MIF increased in T2 and T3, returned to baseline in T4 and rose again at T6. Red blood cell transfusion had no impact on plasma concentrations of IL-­6, IL-­10 and MIF. Plasma concentrations of IL-­2, IL-­4, IL-­17, IFN-­γ and TNF-­α did not change significantly since the induction of anesthesia to the second postoperative day. Regarding the correlation of the concentrations of cytokines with morbidity in the postoperative period, we detected a positive correlation between plasma concentrations of IL-­6 and inotropic score. Different from what occurred with IL-­6, there were no correlations between the concentrations of IL-­10 and MIF and inotropic score. We did not found any correlation among the concentrations of IL-­6, IL-­10 and MIF and the following variables: CPB time, aortic cross-­clamping time, cumulative TISS score, oxygenation index, volume of postoperative bleeding in the first 48 hours, duration of mechanical ventilation and ICU length of stay. Therefore, for this group of patients, characterized as low risk, we have found a significant elevation of plasma concentrations of the mediators IL-­6, IL-­10 and MIF in response to corrective surgery. Packed red blood cells transfusion had no impact on plasma concentrations of these mediators. Also, no correlation was found between elevated concentrations of these mediators and the majority of morbidity related perioperative and postoperative variables that were evaluated.