NEUTROPHIL SEQUESTRATION AND PULMONARY DYSFUNCTION IN A CANINE MODEL OF OPEN-HEART-SURGERY WITH CARDIOPULMONARY BYPASS - EVIDENCE FOR A CD18-DEPENDENT MECHANISM

被引:62
作者
DREYER, WJ
MICHAEL, LH
MILLMAN, EE
BERENS, KL
GESKE, RS
机构
[1] BAYLOR COLL MED,LILLIE FRANK ABERCROMBIE SECT PEDIAT CARDIOL,HOUSTON,TX 77030
[2] BAYLOR COLL MED,SPEROS P MARTEL SECT LEUKOCYTE BIOL & INFLAMMAT R,HOUSTON,TX 77030
[3] BAYLOR COLL MED,DEPT PEDIAT,CARDIOVASC SCI SECT,HOUSTON,TX 77030
[4] BAYLOR COLL MED,DEPT MED,HOUSTON,TX 77030
[5] BAYLOR COLL MED,CTR COMPARAT MED,HOUSTON,TX 77030
关键词
LEUKOCYTES; LUNG; CARDIOPULMONARY BYPASS; ANTIBODIES;
D O I
10.1161/01.CIR.92.8.2276
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Previous studies documented an inflammatory reaction to cardiopulmonary bypass with neutrophil (PMN) sequestration in the lungs, contributing to microvascular injury and postoperative pulmonary dysfunction. This study explored the hypothesis that the beta(2) integrin CD18, a leukocyte adhesion molecule, mediates this response. Methods and Results Fifteen adult, mixed-breed dogs underwent 90 minutes of cardiopulmonary bypass with 3 hours of subsequent recovery. Seven additional dogs were treated before cardiopulmonary bypass with a 1-mg/kg IV bolus of R15.7 IgG, a monoclonal antibody to CD18. Both groups were compared with 5 sham bypass control dogs. Bypassed dogs demonstrated an increased number of PMNs sequestered in the lungs 3 hours after bypass compared with sham bypass control dogs (1466+/-75 versus 516+/-43 PMN/mm(2) alveolar surface area, mean+/-SEM, P<.001). Also, when PMNs from bypass dogs were compared with those from sham dogs, they produced more H2O2 (305+/-45 versus 144+/-48 amol H2O2 per phagocyte per 20 minutes, P<.05). Bypass dogs had significantly decreased arterial oxygenation 3 hours after the proce dure compared with shams (457+/-20 versus 246+/-49 mm Hg, P<.05), and they had a significantly increased lung wet-to-dry weight ratio (5.38+/-0.14 versus 4.54+/-0.15, P=.003), demonstrating a significant increase in lung water. R15.7 markedly attenuated pulmonary PMN accumulation in bypass dogs (412+/-73 PMN/mm(2), P<.001) and significantly inhibited PMN production of H2O2 (146+/-18 amol H2O2 per phagocyte per 20 minutes, P<.05) Bypass dogs pretreated with R15.7 also had improved oxygenation (445+/-28 mm Hg, P<.05) and tended to have less lung water accumulation after bypass (4.99+/-0.20). Conclusions Pulmonary dysfunction after cardiopulmonary bypass is caused, at least in part, by a neutrophil-mediated, CD18-dependent mechanism.
引用
收藏
页码:2276 / 2283
页数:8
相关论文
共 35 条
[1]  
ABBASSI, 1991, J IMMUNOL, V174, P2107
[2]  
ANDERSON BO, 1990, SURGERY, V108, P262
[3]  
BANDO K, 1990, J THORAC CARDIOV SUR, V99, P873
[4]   INCREASED PULMONARY TRANS-VASCULAR PROTEIN FLUX AFTER CANINE CARDIOPULMONARY BYPASS - ASSOCIATION WITH LUNG NEUTROPHIL SEQUESTRATION AND TISSUE PEROXIDATION [J].
BRAUDE, S ;
NOLOP, KB ;
FLEMING, JS ;
KRAUSZ, T ;
TAYLOR, KM ;
ROYSTON, D .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1986, 134 (05) :867-872
[5]   COMPLEMENT ACTIVATION DURING CARDIOPULMONARY BYPASS - EVIDENCE FOR GENERATION OF C3A AND C5A ANAPHYLATOXINS [J].
CHENOWETH, DE ;
COOPER, SW ;
HUGLI, TE ;
STEWART, RW ;
BLACKSTONE, EH ;
KIRKLIN, JW .
NEW ENGLAND JOURNAL OF MEDICINE, 1981, 304 (09) :497-503
[6]   NEUTROPHIL ACTIVATION AND ADHESION MOLECULE EXPRESSION IN A CANINE MODEL OF OPEN-HEART-SURGERY WITH CARDIOPULMONARY BYPASS [J].
DREYER, WJ ;
MICHAEL, LH ;
MILLMAN, EE ;
BERENS, KL .
CARDIOVASCULAR RESEARCH, 1995, 29 (06) :775-781
[7]   NEUTROPHIL ACCUMULATION IN ISCHEMIC CANINE MYOCARDIUM - INSIGHTS INTO TIME COURSE, DISTRIBUTION, AND MECHANISM OF LOCALIZATION DURING EARLY REPERFUSION [J].
DREYER, WJ ;
MICHAEL, LH ;
WEST, MS ;
SMITH, CW ;
ROTHLEIN, R ;
ROSSEN, RD ;
ANDERSON, DC ;
ENTMAN, ML .
CIRCULATION, 1991, 84 (01) :400-411
[8]   NEUTROPHIL ADHERENCE TO ISOLATED ADULT CANINE MYOCYTES - EVIDENCE FOR A CD18-DEPENDENT MECHANISM [J].
ENTMAN, ML ;
YOUKER, K ;
SHAPPELL, SB ;
SIEGEL, C ;
ROTHLEIN, R ;
DREYER, WJ ;
SCHMALSTIEG, FC ;
SMITH, CW .
JOURNAL OF CLINICAL INVESTIGATION, 1990, 85 (05) :1497-1506
[9]   NEUTROPHIL ACTIVATION DURING CARDIOPULMONARY BYPASS [J].
FINN, A ;
REBUCK, N ;
MOAT, N .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1992, 104 (06) :1746-1748
[10]  
Finn A, 1993, PERFUSION, V8, P37