Toomasian Cory J, Aiello Salvatore R, Drumright Benjamin L, Major Terry C, Bartlett Robert H, Toomasian John M
Department of Surgery, Extracorporeal Life Support Laboratory, University of Michigan, Ann Arbor, MI, USA.
Perfusion. 2018 Oct;33(7):538-545. doi: 10.1177/0267659118766157. Epub 2018 Apr 11.
Cardiopulmonary bypass (CPB) is known to cause a systemic inflammatory and immune response.
An in-vitro model of cardiotomy suction was designed to quantify the effects of incrementally increased air-blood exposure on leucocyte marker CD11b and cytokine activation in two common anticoagulants, heparin and citrate.
Fresh human blood was exposed to increasing amounts of air flow for ten minutes. Leucocyte and cytokine levels were measured prior to and after ten minutes of air flow. Cytokine levels were also measured after air exposure when incubated for 24 hours at 37C.
Leucocyte activation, measured by CD11b, was elevated between baseline and air flow rates up to 50 mL/min. After 10 minutes of air exposure, no measured cytokine levels were elevated. After 24 hours of incubation, cytokine levels of TNFα, IL-10, IL-6, and IL-8 were elevated. However, only IL-8 was significantly elevated in citrated blood, but not in heparinized blood, when compared to baseline samples that were also incubated for 24 hours.
This study investigates CD11b levels in response to an air stimulus in blood that was anticoagulated with citrate or heparin. Exposure to an air stimulus activates leucocytes. Activation of CD11b was less when using heparin as an anticoagulant compared to citrate. Cytokine activation occurs with air stimulation, but levels do not immediately rise, indicating that time is required to generate free cytokines.
已知体外循环（CPB）会引发全身性炎症和免疫反应。
设计一种心脏切开术吸引的体外模型，以量化在两种常用抗凝剂肝素和枸橼酸盐中，逐渐增加的气-血接触对白细胞标志物CD11b和细胞因子激活的影响。
将新鲜人血暴露于逐渐增加的空气流中10分钟。在空气流暴露10分钟前后测量白细胞和细胞因子水平。在37℃孵育24小时后，也测量空气暴露后的细胞因子水平。
以CD11b衡量的白细胞激活在基线和高达50 mL/min的空气流速之间升高。空气暴露10分钟后，未检测到细胞因子水平升高。孵育24小时后，TNFα、IL-10、IL-6和IL-8的细胞因子水平升高。然而，与同样孵育24小时的基线样本相比，只有IL-8在枸橼酸盐抗凝血液中显著升高，而在肝素化血液中未显著升高。
本研究调查了用枸橼酸盐或肝素抗凝的血液中，对空气刺激作出反应时的CD11b水平。暴露于空气刺激会激活白细胞。与枸橼酸盐相比，使用肝素作为抗凝剂时CD11b的激活程度较小。空气刺激会引发细胞因子激活，但水平不会立即升高，这表明产生游离细胞因子需要时间。
