Vermeiren Guy L J, Willems Roel, Claeys Marc J, Vrints Chris, Slegers Herman, Jorens Philippe G
Department of Intensive Care, University Hospital of Antwerp, Wilrijkstraat 10, B 2650 Edegem, Belgium.
Mediators Inflamm. 2003 Oct;12(5):269-75. doi: 10.1080/09629350310001619690.
Many papers have focused on the importance of granulocytes in the process of reperfusion and ischemia. Most of the clinical studies measured several parameters of this process during and after coronary angiography, without taking into account the effect of the radiographic contrast media (RCM) used during this procedure.
We performed a randomized patient study (n = 37) to evaluate the effect of ionic and non-ionic RCM on granulocyte adhesion during coronary angiography. We also evaluated the influence of the ionicity and osmolarity of the different substances on granulocyte adhesion molecules in in vitro experiments.
The osmolarity of patient serum samples increased from 302 +/- 1 to 309 +/- 1 mOsm/kg (p < 0.05) after infusion of RCM. The CD11b expression in the samples of the non-ionic RCM treated group increased from 221 +/- 21 MFI to 377 +/- 30 MFI (p < 0.05) measured as the absolute mean fluorescence intensity (MFI), yet did not alter significantly in the ionic RCM group. In contrast, the in vitro experiments showed a reduction of the CD11b expression from 360 +/- 70 MFI to 149 +/- 30 MFI (p < 0.05) in the ionic RCM group.
The upregulation of adhesion molecules was significantly reduced in vivo with ionic RCM, while ionic substances caused opposite effects in vitro. This effect should be taken into account when performing leukocyte functional analysis of samples taken during angiography.
许多论文都聚焦于粒细胞在再灌注和缺血过程中的重要性。大多数临床研究在冠状动脉造影期间及之后测量了该过程的几个参数,却未考虑在此过程中使用的放射造影剂(RCM)的影响。
我们进行了一项随机患者研究(n = 37),以评估离子型和非离子型RCM对冠状动脉造影期间粒细胞黏附的影响。我们还在体外实验中评估了不同物质的离子性和渗透压对粒细胞黏附分子的影响。
输注RCM后,患者血清样本的渗透压从302±1 mOsm/kg增加至309±1 mOsm/kg(p < 0.05)。以绝对平均荧光强度(MFI)衡量,非离子型RCM治疗组样本中的CD11b表达从221±21 MFI增加至377±30 MFI(p < 0.05),而离子型RCM组未显著改变。相比之下,体外实验显示离子型RCM组的CD11b表达从360±70 MFI降至149±30 MFI(p < 0.05)。
离子型RCM在体内显著降低了黏附分子的上调,而离子型物质在体外产生了相反的效果。在对血管造影期间采集的样本进行白细胞功能分析时,应考虑这种效应。