儿科体外循环中的中性粒细胞激活：循环和温度变化的影响。

Neutrophil activation in paediatric extracorporeal circuits: effect of circulation and temperature variation.

作者信息

el Habbal M H, Carter H, Smith L J, Elliott M J, Strobel S

机构信息

Cardiothoracic Unit, Hospital for Sick Children, London, United Kingdom.

出版信息

Cardiovasc Res. 1995 Jan;29(1):102-7.

PMID:7534645

Abstract

OBJECTIVE

Upregulation of neutrophil adhesion molecules (CD11b and L-selectin) and release of a modulating cytokine (IL8) have been reported in vivo and in vitro in adult cardiopulmonary bypass. The aim of this study was to determine whether paediatric bypass preparations have similar influences and whether neutrophil-endothelium interactions are required for IL8 release.

METHODS

In vitro paediatric cardiopulmonary bypass circuits (n = 15) were constructed (identical to those used clinically), as well as static loops (n = 15) using donor blood. The effects of circulation and temperature (17 degrees C, 25 degrees C, 37 degrees C) on the initiation of acute inflammation were examined. Cellular expressions of neutrophil adhesion molecules CD11b and L-selectin were assayed by immunofluorescence technique, and serum IL8, IL6, TNF-alpha, leucocyte elastase, and terminal complement complex were measured by ELISA.

RESULTS

In all experiments, an immediate increase in CD11b expression occurred [median values, in relative fluorescence units: 64.9 (range 45.3-212.9) at rest; 365.2 (205-835.4) at 10 min; P < 0.001], along with a decrease in L-selectin expression [153.5 (115.5-220.7) at rest; 42 (12-134) at 10 min; P < 0.01]. Serum concentrations of the following increased gradually and were higher in circulation than in static loops: IL8 [1500 (500-2500) pg.ml-1 in circuit v 600 (180-1500) pg.ml-1 in loop, P < 0.001]; TNF-alpha P < 0.05]; and terminal complement complex [25.9 (6.8-120) v 4.7 (0-21.6) AU.ml-1, P < 0.01]. Cooling decreased and rewarming increased upregulation of CD11b and downregulation of L-selectin and release of IL8. IL6 was undetectable.

CONCLUSIONS

In the absence of endothelium, in vitro paediatric cardiopulmonary bypass causes profound acute inflammatory changes in donor blood with release of IL8. These changes were greater than in adult cardiopulmonary bypass. Temperature variation and circulation modulate the responses.

摘要

目的

在成人体外循环的体内和体外实验中均已报道中性粒细胞黏附分子（CD11b和L-选择素）上调以及一种调节性细胞因子（IL8）的释放。本研究的目的是确定儿科体外循环制剂是否有类似影响，以及IL8释放是否需要中性粒细胞与内皮细胞相互作用。

方法

构建了体外儿科体外循环回路（n = 15）（与临床使用的相同），以及使用供血的静态回路（n = 15）。研究了循环和温度（17℃、25℃、37℃）对急性炎症启动的影响。通过免疫荧光技术检测中性粒细胞黏附分子CD11b和L-选择素的细胞表达，并通过ELISA测定血清IL8、IL6、TNF-α、白细胞弹性蛋白酶和末端补体复合物。

结果

在所有实验中，CD11b表达立即增加[相对荧光单位的中位数：静息时为64.9（范围45.3 - 212.9）；10分钟时为365.2（205 - 835.4）；P < 0.001]，同时L-选择素表达降低[静息时为153.5（115.5 - 220.7）；10分钟时为42（12 - 134）；P < 0.01]。以下物质的血清浓度逐渐升高，且循环中的浓度高于静态回路：IL8[回路中为1500（500 - 2500）pg.ml-1，回路中为600（180 - 1500）pg.ml-1，P < 0.001]；TNF-α（P < 0.05）；以及末端补体复合物[25.9（6.8 - 120）对4.7（0 - 21.6）AU.ml-1，P < 0.01]。降温使CD11b的上调、L-选择素的下调和IL8的释放减少，复温则使其增加。未检测到IL6。