Hill G E, Alonso A, Thiele G M, Robbins R A
Department of Anesthesiology, University of Nebraska Medical Center, Omaha 68198-4455.
Anesth Analg. 1994 Jul;79(1):23-7. doi: 10.1213/00000539-199407000-00006.
Neutrophil-endothelial adhesion is the initiating event in neutrophil migration to areas of infection or injury. The binding of neutrophils to endothelium depends upon adhesive glycoproteins, of which the CD11/CD18 glycoproteins are the most important. Because of known upregulation of one of these adhesive glycoproteins (CD11b) during cardiopulmonary bypass (CPB) in humans, we evaluated CD11a, CD11b, and CD11c surface expression before, during, and after CPB in humans, with or without pre-CPB administration of a glucocorticoid (methylprednisolone). Fourteen patients were randomized into two groups: Group S received methylprednisolone (1 g intravenously) 5 min prior to CPB; Group N received no steroid. CD11b was significantly upregulated (P < 0.01) during, and 24 h after, CPB in Group N when compared with controls and Group S at similar time intervals, while in Group S no significant changes were found. Since interleukin-1, tumor necrosis factor, and endotoxin are known to upregulate neutrophil CD11b surface expression and are released during CPB in humans, while steroids are known to suppress the release of these cytokines, the authors conclude that the blunting effect by steroids on CD11b surface expression upregulation during and after CPB in humans is attributed to suppressed cytokine release.
中性粒细胞与内皮细胞的黏附是中性粒细胞迁移至感染或损伤部位的起始事件。中性粒细胞与内皮细胞的结合依赖于黏附糖蛋白，其中CD11/CD18糖蛋白最为重要。由于已知人类体外循环（CPB）期间这些黏附糖蛋白之一（CD11b）会上调，我们评估了人类CPB前、中、后的CD11a、CD11b和CD11c表面表达，无论是否在CPB前给予糖皮质激素（甲泼尼龙）。14例患者随机分为两组：S组在CPB前5分钟静脉注射甲泼尼龙（1g）；N组未接受类固醇治疗。与对照组和S组在相似时间间隔相比，N组在CPB期间及CPB后24小时CD11b显著上调（P<0.01），而S组未发现显著变化。由于已知白细胞介素-1、肿瘤坏死因子和内毒素会上调中性粒细胞CD11b表面表达且在人类CPB期间释放，而类固醇已知可抑制这些细胞因子的释放，作者得出结论，类固醇对人类CPB期间及之后CD11b表面表达上调的钝化作用归因于细胞因子释放受到抑制。
