Kuebler W M, Borges J, Sckell A, Kuhnle G E, Bergh K, Messmer K, Goetz A E
Institute for Surgical Research and Department of Anesthesiology, University of Munich, Germany.
Am J Respir Crit Care Med. 2000 Jan;161(1):36-43. doi: 10.1164/ajrccm.161.1.9901039.
After a variety of pathophysiologic stimuli, neutrophils accumulate in lung capillaries and contribute to the pathogenesis of acute lung injury. Lung neutrophil sequestration has previously been attributed to mechanical retention of stiffened neutrophils, but L-selectin-mediated leukocyte/endothelial interaction may be an essential step. We investigated the effect of the anti-L-selectin antibody HuDreg 200 on leukocyte sequestration and microhemodynamics in alveolar capillaries in a model of acute endotoxemia. We used in vivo fluorescence microscopy to analyze kinetics of fluorescently labeled red and white blood cells in alveolar capillary networks of the rabbit lung. Investigations were performed over 2 h after an intravenous infusion of 0.2 ml/kg body weight (bw) NaCl, 2 mg/kg bw HuDreg 200, 20 microg/kg bw lipopolysaccharide (LPS) of Escherichia coli 0111:B4, or the combination of HuDreg 200 and LPS, respectively. Infusion of LPS induced leukocyte sequestration in alveolar capillaries, which was accompanied by a reduction of alveolar capillary perfusion and functional capillary density. These effects could be completely blocked by pretreatment of animals with HuDreg 200. We conclude that L-selectin-mediated leukocyte/endothelial interaction is a necessary prerequisite for leukocyte sequestration in alveolar capillaries in this model. Impaired alveolar capillary perfusion appeared to result directly from capillary leukocyte sequestration.
在受到多种病理生理刺激后,中性粒细胞在肺毛细血管中积聚,并参与急性肺损伤的发病机制。肺中性粒细胞滞留以前被认为是由于僵化的中性粒细胞机械性滞留,但L-选择素介导的白细胞/内皮细胞相互作用可能是一个关键步骤。我们在急性内毒素血症模型中研究了抗L-选择素抗体HuDreg 200对肺泡毛细血管中白细胞滞留和微血流动力学的影响。我们使用体内荧光显微镜分析兔肺肺泡毛细血管网络中荧光标记的红细胞和白细胞的动力学。分别在静脉注射0.2 ml/kg体重(bw)的NaCl、2 mg/kg bw的HuDreg 200、20 μg/kg bw的大肠杆菌0111:B4脂多糖(LPS)或HuDreg 200与LPS的组合后2小时内进行研究。注射LPS可诱导肺泡毛细血管中的白细胞滞留,同时伴有肺泡毛细血管灌注和功能性毛细血管密度降低。用HuDreg 200对动物进行预处理可完全阻断这些作用。我们得出结论,在该模型中,L-选择素介导的白细胞/内皮细胞相互作用是肺泡毛细血管中白细胞滞留的必要前提。肺泡毛细血管灌注受损似乎直接源于毛细血管白细胞滞留。