Bilfinger T V, Stefano G
Department of Surgery, State University of New York, Stony Brook 11794-8191.
J Cardiovasc Surg (Torino). 1993 Apr;34(2):129-33.
Previous studies have demonstrated that cardiopulmonary bypass (CPB) induces a diffuse inflammatory response as well as cellular immunosuppression. To better characterize and localize this immune dysfunction, we examined the effect of CPB-exposed plasma on granulocytes and macrophages obtained from normal blood. Pre- and intra-CPB blood samples were obtained from seven patients admitted for elective coronary artery bypass graft surgery. Plasma from the pre-CPB samples served as controls. Evaluation of the behavior of the granulocytes and macrophages was based on their ability to respond by way of chemokinesis or chemotaxis versus a stimulus (D-Ala2-Met5-enkephalin [DAME], interleukin[IL]-1 alpha). Non-CPB exposed granulocytes and macrophages were found to be capable of chemotaxis when stimulated by DAME and by IL-1 alpha. Subjected to CPB, these cells were significantly more activated than controls (p < 0.005). They behaved in a chemokinetic fashion when incubated with cell-free CPB plasma and did not respond to either DAME or IL-1 alpha in a chemotaxic situation when compared with controls (p < 0.005). Plasma subjected to CPB as stimulus provoked a chemotaxic response in non-CPB exposed cells. Taken together, these results indicate that at least one type of potent signal molecule was present, and possibly generated, in plasma subjected to CPB.
以往研究表明，体外循环（CPB）可引发弥漫性炎症反应及细胞免疫抑制。为更好地描述和定位这种免疫功能障碍，我们检测了CPB处理过的血浆对从正常血液中获取的粒细胞和巨噬细胞的影响。CPB前和CPB期间的血样取自7例因择期冠状动脉搭桥手术入院的患者。CPB前血样的血浆用作对照。对粒细胞和巨噬细胞行为的评估基于它们通过趋化作用或趋化性对刺激物（D-丙氨酸2-甲硫氨酸5-脑啡肽[DAME]、白细胞介素[IL]-1α）作出反应的能力。未接触CPB的粒细胞和巨噬细胞在受到DAME和IL-1α刺激时能够发生趋化作用。经过CPB处理后，这些细胞的激活程度明显高于对照组（p<0.005）。与对照组相比，当与无细胞的CPB血浆一起孵育时，它们表现出趋化运动方式，在趋化情况下对DAME或IL-1α均无反应（p<0.005）。经过CPB处理的血浆作为刺激物可在未接触CPB的细胞中引发趋化反应。综上所述，这些结果表明，经过CPB处理的血浆中至少存在一种且可能产生了一种强效信号分子。
