TY - JOUR
T1 - Neutrophil adhesion molecule expression during cardiopulmonary bypass with bubble and membrane oxygenators
AU - Gillinov, A. Marc
AU - Bator, Jenny M.
AU - Zehr, Kenton J
AU - Redmond, J. Mark
AU - Burch, Ronald M.
AU - Ko, Chiew
AU - Winkelstein, Jerry A.
AU - Stuart, R. Scott
AU - Baumgartner, William A.
AU - Cameron, Duke E.
N1 - Funding Information:
Supported by USPHS NIH grant R01 H47191-01. We gratefully acknowledge the expert technical assistance of Melissa Haggerty, Ernest King, and Andrea Swift. In addition, we thank Lori Garrison for assistance in the preparation of the manuscript.
PY - 1993/10
Y1 - 1993/10
N2 - The neutrophil-mediated tissue injury associated with cardiopulmonary bypass (CPB) is thought to require the interaction of specific neutrophil and endothelial adhesion molecules. In this study, the effects of CPB on the expression of neutrophil CD11b and CD18 (the components of the Mac-1 adhesion molecule) were examined; the effects of membrane versus bubble oxygenators on the expression of neutrophil CD11b and CD18 were compared; and the plasma levels of the intercellular adhesion molecule-1 (cICAM-1), an inducible endothelial adhesion molecule, were measured. In addition, the time courses of complement activation and neutrophil granule release were measured to determine their temporal relationship to the expression of the neutrophil adhesion molecule. Fifteen adult patients underwent procedures requiring cardiopulmonary bypass; hollow-fiber membrane oxygenators were used in 8 (group M) and bubble oxygenators were used in 7 (group B). Blood samples were drawn before, during, and after CPB for determination of the expression of neutrophil CD11b and CD18 (immunofluorescent flow cytometry), and the plasma cICAM-1, elastase, lactoferrin (enzyme-linked immunoabsorbent assay), and plasma C3a (radioimmunoassay) levels. CPB caused an immediate and sustained increase in the neutrophil CD11b and CD18 expression in both groups; after 60 minutes of CPB, CD11b expression had increased by 116.9% ± 19.1% in group B and by 79.3% ± 8.5% in group M (p = 0.78). Over the same period, CD18 expression increased by 97.2% ± 17.9% in group B and by 72.4% ± 16.8% in group M (p = 0.67). Increased neutrophil adhesion molecule expression was accompanied by elevations in the plasma elastase, lactoferrin, and C3a levels; there were no differences between oxygenator groups for any of these parameters. Before CPB, the plasma cICAM-1 levels were similar in the two groups (group B, 175.6 ± 25.6 ng/ml; group M, 200.2 ± 30 ng/ml). Twenty-four hours after CPB, the plasma cICAM-1 level increased to 289.1 ± 31.1 ng/ml in group B patients (p < 0.004 versus the baseline) but did not increase in group M patients (220.5 ± 20.6 ng/ml). These results demonstrate that (1) CPB causes upregulation of the neutrophil adhesion molecule subunits CD11b and CD18; (2) the bubble and membrane oxygenators used in this study cause similar degrees of neutrophil adhesion molecule upregulation, neutrophil degranulation, and complement activation; and (3) use of bubble, but not membrane, oxygenators results in increased plasma cICAM-1 levels.
AB - The neutrophil-mediated tissue injury associated with cardiopulmonary bypass (CPB) is thought to require the interaction of specific neutrophil and endothelial adhesion molecules. In this study, the effects of CPB on the expression of neutrophil CD11b and CD18 (the components of the Mac-1 adhesion molecule) were examined; the effects of membrane versus bubble oxygenators on the expression of neutrophil CD11b and CD18 were compared; and the plasma levels of the intercellular adhesion molecule-1 (cICAM-1), an inducible endothelial adhesion molecule, were measured. In addition, the time courses of complement activation and neutrophil granule release were measured to determine their temporal relationship to the expression of the neutrophil adhesion molecule. Fifteen adult patients underwent procedures requiring cardiopulmonary bypass; hollow-fiber membrane oxygenators were used in 8 (group M) and bubble oxygenators were used in 7 (group B). Blood samples were drawn before, during, and after CPB for determination of the expression of neutrophil CD11b and CD18 (immunofluorescent flow cytometry), and the plasma cICAM-1, elastase, lactoferrin (enzyme-linked immunoabsorbent assay), and plasma C3a (radioimmunoassay) levels. CPB caused an immediate and sustained increase in the neutrophil CD11b and CD18 expression in both groups; after 60 minutes of CPB, CD11b expression had increased by 116.9% ± 19.1% in group B and by 79.3% ± 8.5% in group M (p = 0.78). Over the same period, CD18 expression increased by 97.2% ± 17.9% in group B and by 72.4% ± 16.8% in group M (p = 0.67). Increased neutrophil adhesion molecule expression was accompanied by elevations in the plasma elastase, lactoferrin, and C3a levels; there were no differences between oxygenator groups for any of these parameters. Before CPB, the plasma cICAM-1 levels were similar in the two groups (group B, 175.6 ± 25.6 ng/ml; group M, 200.2 ± 30 ng/ml). Twenty-four hours after CPB, the plasma cICAM-1 level increased to 289.1 ± 31.1 ng/ml in group B patients (p < 0.004 versus the baseline) but did not increase in group M patients (220.5 ± 20.6 ng/ml). These results demonstrate that (1) CPB causes upregulation of the neutrophil adhesion molecule subunits CD11b and CD18; (2) the bubble and membrane oxygenators used in this study cause similar degrees of neutrophil adhesion molecule upregulation, neutrophil degranulation, and complement activation; and (3) use of bubble, but not membrane, oxygenators results in increased plasma cICAM-1 levels.
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U2 - 10.1016/0003-4975(93)90342-F
DO - 10.1016/0003-4975(93)90342-F
M3 - Article
C2 - 8105757
AN - SCOPUS:0027489067
SN - 0003-4975
VL - 56
SP - 847
EP - 853
JO - The Annals of thoracic surgery
JF - The Annals of thoracic surgery
IS - 4
ER -