Hofbauer R, Moser D, Hornykewycz S, Frass M, Kapiotis S
Clinical Institute of Medical and Chemical Laboratory Diagnostics, the Department of Anesthesiology, University of Vienna, Austria.
Transfusion. 1999 Mar;39(3):289-94. doi: 10.1046/j.1537-2995.1999.39399219286.x.
Polymorphonuclear leukocytes (PMNs) play a tremendous role during inflammatory processes. PMNs have to pass a monolayer of endothelial cells to migrate into the extravascular space. Hydroxyethyl starch (HES) is frequently used as a volume expander in critically ill patients.
The aim of this study was to investigate whether HES influences the chemotaxis of PMNs through endothelial cell monolayers by using a test system that allows the simultaneous treatment of both cell types. Human umbilical endothelial cells were cultured on microporous membrane filters. PMNs were isolated and PMN chemotaxis was studied.
The number of untreated PMNs that migrated through untreated endothelial cell monolayers in response to a chemoattractant was used as a control and set as 100 percent. In clinically relevant concentrations, HES was able to significantly decrease PMN chemotaxis through endothelial cell monolayers, showing a dose-dependent effect (0.1 mg/mL: 99.6 +/- 10.9%, p = NS compared to control; 1 mg/mL: 82.4 +/- 8.3%, p<0.05 compared to control; 10 mg/mL: 62.9 +/- 11.7%, p<0.05). In this assay, both cell types (PMNs and endothelial cells in the monolayer) were treated simultaneously, which simulated the clinical situation after an intravenous injection of HES. The treatment of one cell type, PMNs (89.6 +/- 8.8%, p<0.05) or endothelial cells in the monolayer (76.2 +/- 9.4%, p<0.05), suggests that the influence on endothelial cells is greater.
HES is able to significantly reduce the chemotaxis of PMNs through endothelial cell monolayers. The possible clinical consequence of a moderate reduction in endothelium-mediated PMN chemotaxis in critically ill patients remains to be evaluated.
多形核白细胞（PMN）在炎症过程中发挥着巨大作用。PMN必须穿过单层内皮细胞才能迁移到血管外间隙。羟乙基淀粉（HES）在危重病患者中经常用作容量扩充剂。
本研究的目的是通过使用一种能够同时处理两种细胞类型的测试系统，研究HES是否通过内皮细胞单层影响PMN的趋化性。人脐内皮细胞在微孔膜滤器上培养。分离PMN并研究PMN趋化性。
将未处理的PMN在趋化因子作用下穿过未处理的内皮细胞单层的数量用作对照并设定为100%。在临床相关浓度下，HES能够显著降低PMN通过内皮细胞单层的趋化性，呈现剂量依赖性效应（0.1mg/mL：99.6±10.9%，与对照相比p=无显著性差异；1mg/mL：82.4±8.3%，与对照相比p<0.05；10mg/mL：62.9±11.7%，p<0.05）。在该试验中，两种细胞类型（单层中的PMN和内皮细胞）同时进行处理，这模拟了静脉注射HES后的临床情况。对一种细胞类型（PMN，89.6±8.8%，p<0.05）或单层中的内皮细胞（76.2±9.4%，p<0.05）进行处理，表明对内皮细胞的影响更大。
HES能够显著降低PMN通过内皮细胞单层的趋化性。危重病患者内皮介导的PMN趋化性适度降低的可能临床后果仍有待评估。
