Sutter P M, Spagnoli G C, Marx A, Gürke L, Troeger H, Fricker R, Harder F, Heberer M
Department of Surgery, Kantonsspital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
World J Surg. 1997 Feb;21(2):179-84; discussion 185. doi: 10.1007/s002689900212.
The surface expression of beta2-integrins was investigated in leukocytes from patients undergoing ischemia induced by tourniquet application for elective hand surgery. Blood samples were obtained before initiation, at the end of ischemia, and after 15 minutes of reperfusion from ischemic and contralateral arms of five patients. Comparable expression of CD18, CD11a, CD11b, and CD11c could be detected by immunofluorescence in leukocytes from samples drawn from either arm before tourniquet application. In contrast, a significant increase in the expression of CD18 was detectable in monocytes, granulocytes, and lymphocytes from the ischemic arm compared with that in the nonischemic contralateral control, at the end of the ischemia time (80 +/- 16 minutes). A significantly increased expression of CD11b, but not CD11a or CD11c, determinants was also observed in granulocytes and monocytes. Concomitantly, a significant reduction in the percentages of granulocytes in samples from ischemic areas was detectable. After 15 minutes of reperfusion, differences in the expression of these adhesion molecules were no longer significant. The expression of the genes encoding interleukins IL-1alpha, IL-1beta, and IL-6 and tumor necrosis factor alpha (TNFalpha) proinflammatory cytokines was also studied by reverse polymerase chain reaction (rPCR) in peripheral blood mononuclear cells (PBMCs) obtained from the same samples in three patients. IL-1beta or IL-6 gene expression was never observed. Expression of IL-1alpha and TNFalpha genes, as detected in two patients, was not related with induction of ischemia. However, in these patients expression of one or both these genes was observed in samples derived from the ischemic but not the control arm after 15 minutes of reperfusion. These data document that overexpression of adhesion molecules and sequestration of leukocytes take place following short ischemia times, as routinely applied clinically for minor surgical procedures.
在接受因择期手部手术使用止血带导致局部缺血的患者的白细胞中，对β2整合素的表面表达进行了研究。在五名患者的缺血手臂和对侧手臂，于缺血开始前、缺血结束时以及再灌注15分钟后采集血样。在止血带应用前从任一手臂采集的样本中的白细胞中，通过免疫荧光可检测到CD18、CD11a、CD11b和CD11c的表达相当。相比之下，在缺血时间结束时（80±16分钟），与非缺血对侧对照相比，缺血手臂的单核细胞、粒细胞和淋巴细胞中CD18的表达显著增加。在粒细胞和单核细胞中也观察到CD11b决定簇的表达显著增加，但CD11a或CD11c未增加。同时，可检测到缺血区域样本中粒细胞百分比显著降低。再灌注15分钟后，这些黏附分子表达的差异不再显著。还通过逆转录聚合酶链反应（rPCR）在从三名患者相同样本中获得的外周血单核细胞（PBMC）中研究了编码白细胞介素IL-1α、IL-1β和IL-6以及肿瘤坏死因子α（TNFα）促炎细胞因子的基因表达。从未观察到IL-1β或IL-6基因表达。在两名患者中检测到的IL-1α和TNFα基因表达与缺血诱导无关。然而，在这些患者中，再灌注15分钟后，在来自缺血手臂而非对照手臂的样本中观察到了这一种或两种基因的表达。这些数据表明，在临床常规用于小型手术的短时间缺血后，会发生黏附分子的过表达和白细胞的隔离。
