Light Therapy in Cardiopulmonary Bypass Surgery
| Status: | Recruiting |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/16/2019 |
| Start Date: | April 1, 2019 |
| End Date: | December 31, 2019 |
| Contact: | Matthew R Rosengart, MD MPH |
| Email: | mrr18@pitt.edu |
| Phone: | 412.647.0597 |
The goal of this study is to determine whether or not exposure to blue spectrum light reduces
acute kidney injury and systemic inflammation in subjects undergoing cardiopulmonary bypass.
Subjects scheduled to undergo cardiopulmonary bypass surgery will be exposed to either bright
(1000 lux) blue spectrum (480nm) light or to ambient, white fluorescent light for a 24 hour
photoperiod the day prior to surgery and for a 24 hour photoperiod in the immediate
postoperative period.
acute kidney injury and systemic inflammation in subjects undergoing cardiopulmonary bypass.
Subjects scheduled to undergo cardiopulmonary bypass surgery will be exposed to either bright
(1000 lux) blue spectrum (480nm) light or to ambient, white fluorescent light for a 24 hour
photoperiod the day prior to surgery and for a 24 hour photoperiod in the immediate
postoperative period.
Light modifies the biology and physiology of mammals, including humans. The cellular biology
of both the immune system, as well as, the cells comprising tissues and organs (e.g., kidney,
liver) are under the regulation of light and exhibit circadian rhythms. Studies show that the
severity of organ injury varies with the time of the day, the duration of the day, and the
season. This variation is due to the biology of circadian rhythms, and light is the principle
environmental cue entraining circadian biology. More recent data suggest that modulating the
spectrum of light to which an organism is exposed may therapeutically modulate the cellular
response to stress or injury. Specifically, exposure to a short (24 hour) photoperiod of high
illuminance, blue spectrum light attenuated liver and kidney injury when animals were
subjected to ischemia/reperfusion (I/R), a model in which the blood flow to an organ is
temporarily reduced and then restored. A predominant cause of organ injury in this model is
the misdirected and exacerbated inflammation of a type of immune cell called the neutrophil.
However, blue light inhibited neutrophil infiltration into the ischemic kidney and liver, and
thereby reduced inflammation and neutrophil-mediated organ injury.
Cardiopulmonary bypass (CPB) surgery is an operation characterized by excessive inflammation
and a high risk of organ injury, particularly acute kidney injury (AKI). Thus, we hypothesize
that exposure to blue light, by comparison to standard environmental, white fluorescent
light, will reduce inflammation, organ injury and improve the outcome of patients undergoing
CPB.
of both the immune system, as well as, the cells comprising tissues and organs (e.g., kidney,
liver) are under the regulation of light and exhibit circadian rhythms. Studies show that the
severity of organ injury varies with the time of the day, the duration of the day, and the
season. This variation is due to the biology of circadian rhythms, and light is the principle
environmental cue entraining circadian biology. More recent data suggest that modulating the
spectrum of light to which an organism is exposed may therapeutically modulate the cellular
response to stress or injury. Specifically, exposure to a short (24 hour) photoperiod of high
illuminance, blue spectrum light attenuated liver and kidney injury when animals were
subjected to ischemia/reperfusion (I/R), a model in which the blood flow to an organ is
temporarily reduced and then restored. A predominant cause of organ injury in this model is
the misdirected and exacerbated inflammation of a type of immune cell called the neutrophil.
However, blue light inhibited neutrophil infiltration into the ischemic kidney and liver, and
thereby reduced inflammation and neutrophil-mediated organ injury.
Cardiopulmonary bypass (CPB) surgery is an operation characterized by excessive inflammation
and a high risk of organ injury, particularly acute kidney injury (AKI). Thus, we hypothesize
that exposure to blue light, by comparison to standard environmental, white fluorescent
light, will reduce inflammation, organ injury and improve the outcome of patients undergoing
CPB.
Inclusion Criteria:
- age greater than or equal to 18 years
- undergoing cardiopulmonary bypass surgery
Exclusion Criteria:
- Blindness
- Immunocompromised or immunosuppressed state
- Anticipated survival < 24 hours
We found this trial at
1
site
Click here to add this to my saved trials
