Dreyer W J, Michael L H, Millman E E, Berens K L
Baylor College of Medicine, Houston, Texas, USA.
Cardiovasc Res. 1995 Jun;29(6):775-81.
The aim was to determine whether, in a canine model, changes in surface expression of the neutrophil adhesion molecules CD11b/CD18 and L-selectin during and after open heart surgery with cardiopulmonary bypass can be used to identify subjects at risk for postoperative pulmonary dysfunction.
Adult mixed breed dogs underwent cardiopulmonary bypass and were compared to "sham bypass" controls. Flow cytometry was performed on blood from the two groups of dogs and changes in CD11b/CD18 adhesion molecules and L-selectin were investigated.
Flow cytometry on blood from bypass dogs showed increased CD18 expression during and after cardiopulmonary bypass and a reciprocal decrease in L-selectin expression. Sham animals showed no significant change. In the bypass animals, changes in adhesion molecule expression were not evenly distributed across the population of circulating neutrophils; however, they were indicative of a percentage of activated cells. There was a significant negative linear relationship between the percentage of activated cells and arterial oxygenation 3 h after bypass (r = -0.80, P < 0.001). From this analysis, 11 animals were identified as "high" responders and seven as "low" responders, with different patterns of cellular activation and oxygenation during and after bypass. High responders had an average of 40(SEM 5)% activated cells during bypass with a persistently raised percentage of activated cells [38(3)%] 3 h later, whereas low responders had only 22(6)% activated cells during bypass and 11(2)% activated cells 3 h after bypass. High responder animals had a marked and continued deterioration in PO2 after bypass [to 25(6)% of baseline 3 h after bypass] whereas low responder animals showed recovery of oxygenation after the first hour postbypass and improved to 80(8)% of baseline at 3 h.
Changes in adhesion molecule expression serve as a marker of neutrophil activation during cardiopulmonary bypass. The percentage of activated neutrophils in the circulation within 3 h after cardiopulmonary bypass may be predictive of an ongoing inflammatory process that is linked to pulmonary dysfunction.
旨在确定在犬类模型中，体外循环心脏直视手术期间及术后中性粒细胞黏附分子CD11b/CD18和L-选择素的表面表达变化是否可用于识别术后发生肺功能障碍的高危受试者。
成年杂种犬接受体外循环，并与“假体外循环”对照组进行比较。对两组犬的血液进行流式细胞术检测，研究CD11b/CD18黏附分子和L-选择素的变化。
对体外循环犬的血液进行流式细胞术检测显示，体外循环期间及术后CD18表达增加，L-选择素表达相应降低。假手术动物无显著变化。在体外循环动物中，黏附分子表达的变化在循环中性粒细胞群体中分布不均；然而，它们表明了一定比例的活化细胞。体外循环后3小时，活化细胞百分比与动脉氧合之间存在显著的负线性关系（r = -0.80，P < 0.001）。通过该分析，11只动物被确定为“高”反应者，7只为“低”反应者，在体外循环期间及术后具有不同的细胞活化和氧合模式。高反应者在体外循环期间平均有40（标准误5）%的活化细胞，3小时后活化细胞百分比持续升高[38（3）%]，而低反应者在体外循环期间仅有22（6）%的活化细胞，体外循环后3小时为11（2）%。高反应者动物在体外循环后PO2显著且持续恶化[体外循环后3小时降至基线的25（6）%]，而低反应者动物在体外循环后第一小时后氧合恢复，3小时时改善至基线的80（8）%。
黏附分子表达变化可作为体外循环期间中性粒细胞活化的标志物。体外循环后3小时内循环中活化中性粒细胞的百分比可能预示着与肺功能障碍相关的持续炎症过程。
