Bugajski P, Kalawski R, Baliński M, Wysocki H, Olszewski R, Szczepanik A, Siminiak T
Department of Cardiosurgery, J. Strus Hospital, Poznań, Poland.
Thorac Cardiovasc Surg. 1999 Jun;47(3):144-7. doi: 10.1055/s-2007-1013129.
Activation of polymorphonuclear neutrophils (PMN) and subsequent release of free oxygen radicals, including the superoxide anion (O2-) has been shown to result in postischaemic myocardial dysfunction during coronary artery bypass grafting (CABG). Several neutrophil-oriented stimuli are known to be released from myocardium during ischaemia and reperfusion. Release of endothelin-1 has been documented during CABG. The aim of the current study was to evaluate plasma-mediated neutrophil stimulation and to verify whether endothelin-1, known to be a stimulus for PMN, is involved in plasma-mediated stimulation of PMN during coronary artery bypass grafting.
Plasma samples from peripheral artery, peripheral vein, and coronary sinus were obtained from 21 patients undergoing CABG before aortic clamping (global ischaemia), immediately after beginning reperfusion, and 30 min after reperfusion as well as from healthy controls. Plasma was incubated with PMN isolated from healthy donors preincubated in the presence of saline or specific endothelin-1 receptor antagonist (ET-A). PMN O2- production was measured spectrophotometrically.
Plasma samples taken from the coronary sinus at the beginning of reperfusion were capable of higher stimulation of neutrophil superoxide anion production (24.2 +/- 2.0 nmol/5 x 10(6)PMN/30 min) than plasma obtained before reperfusion (15.6 +/- 1.5; p < 0.05) or plasma taken from peripheral artery (17.1 +/- 1.7; p < 0.05). Preincubation of PMN with endothelin-1 receptor antagonist decreased superoxide anion production by cells exposed to plasma taken from coronary sinus at the beginning of reperfusion (17.6 +/- 2.0, p < 0.05).
Transcardiac release of soluble stimuli for PMN occurs as a result of myocardial ischaemia during CABG. Endothelin-1 may be involved in the plasma-mediated stimulation of neutrophil superoxide anion production.
多形核中性粒细胞（PMN）的激活以及随后包括超氧阴离子（O2-）在内的游离氧自由基的释放已被证明会导致冠状动脉旁路移植术（CABG）期间的缺血后心肌功能障碍。已知在缺血和再灌注期间，心肌会释放几种以中性粒细胞为导向的刺激物。在CABG期间已记录到内皮素-1的释放。本研究的目的是评估血浆介导的中性粒细胞刺激，并验证已知为PMN刺激物的内皮素-1是否参与冠状动脉旁路移植术期间血浆介导的PMN刺激。
从21例接受CABG的患者在主动脉钳夹前（全心缺血）、再灌注开始后立即以及再灌注30分钟后采集外周动脉、外周静脉和冠状窦的血浆样本，同时采集健康对照者的血浆样本。将血浆与从预先在生理盐水或特异性内皮素-1受体拮抗剂（ET-A）存在下孵育的健康供体中分离出的PMN一起孵育。通过分光光度法测量PMN的O2-产生量。
再灌注开始时从冠状窦采集的血浆样本比再灌注前采集的血浆（15.6±1.5；p<0.05）或从外周动脉采集的血浆（17.1±1.7；p<0.05）更能刺激中性粒细胞超氧阴离子的产生（24.2±2.0 nmol/5×10(6)PMN/30分钟）。用内皮素-1受体拮抗剂对PMN进行预孵育可降低暴露于再灌注开始时从冠状窦采集的血浆中的细胞的超氧阴离子产生量（17.6±2.0，p<0.05）。
CABG期间心肌缺血导致可溶性PMN刺激物经心脏释放。内皮素-1可能参与血浆介导的中性粒细胞超氧阴离子产生的刺激。
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