Lefer A M
Department of Physiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ann Thorac Surg. 1995 Sep;60(3):773-7. doi: 10.1016/0003-4975(95)00424-J.
During reperfusion of ischemic myocardium, there is a well-orchestrated interplay between the coronary vascular endothelium and the circulating neutrophils. This interplay involves the initial slowing or "rolling" of neutrophils along the endothelium during the early moments of reperfusion, followed by firm attachment and amplification of the neutrophil response, and culminating with the diapedesis of neutrophils into the myocardial parenchyma where neutrophil-myocyte interaction contributes to the necrotic process. The selectins are glycoproteins that play a key role in the early phases of neutrophil adherence and activation. There are three members of the selectin family: P-selectin on endothelial cells and platelets, L-selectin on neutrophils, and E-selectin on endothelium. Monoclonal antibodies directed specifically toward these selectins and their associated ligands (eg, Sialyl Lewisx) not only substantiate their role in the dynamic process of neutrophil-mediated reperfusion injury but also offer a unique therapeutic opportunity to interfere with this cascade of inflammatory events.
在缺血心肌的再灌注过程中，冠状动脉血管内皮细胞与循环中的中性粒细胞之间存在精心编排的相互作用。这种相互作用包括再灌注早期中性粒细胞沿内皮细胞的初始减慢或“滚动”，随后是中性粒细胞反应的牢固附着和放大，最终以中性粒细胞渗入心肌实质为高潮，在那里中性粒细胞与心肌细胞的相互作用促成坏死过程。选择素是糖蛋白，在中性粒细胞黏附和激活的早期阶段起关键作用。选择素家族有三个成员：内皮细胞和血小板上的P选择素、中性粒细胞上的L选择素以及内皮细胞上的E选择素。特异性针对这些选择素及其相关配体（如唾液酸化路易斯x）的单克隆抗体不仅证实了它们在中性粒细胞介导的再灌注损伤动态过程中的作用，还提供了一个独特的治疗机会来干扰这一系列炎症事件。
