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Polymorphonuclear Cell—Mediated Vascular Injury in Anergic Surgical Patients

Polymorphonuclear Cell—Mediated Vascular Injury in Anergic Surgical Patients Abstract • We examined the responses of primed polymorphonuclear neutrophils (PMNs) adhered to vascular endothelium, which can lead to endothelial cell damage as a mechanism of the capillary leak syndrome, the main cause of death in anergic patients. We tested PMNs from (1) preoperative reactive patients, (2) preoperative anergic patients, (3) anergic patients in the surgical intensive care unit, and (4) healthy controls for in vitro adherence and cytotoxicity on cultured human vein endothelial cells. Adherence of PMNs was 12.9%±3.9% in preoperative anergic patients and 13.1%±3.2% in anergic patients in the surgical intensive care unit compared with 9.0%±2.1% in preoperative reactive patients (P<.05). Cytotoxicity was 6.0%±2.8% in preoperative reactive patients, 13.7%±4.1% in preoperative anergic patients, and 14.3%±4.6% in anergic patients in the surgical intensive care unit. The PMNs from preoperative anergic patients were more cytotoxic against human vein endothelial cells when stimulated by Staphylococcus epidermidis or formyl-methionyleucylphenylalanine. We conclude that PMNs from anergic surgical patients adhere more to endothelial cells and can produce increased cytotoxicity that may lead to detrimental results. (Arch Surg. 1993;128:68-72) References 1. Christou NV. Host defense mechanisms in surgical patients: a correlative study of the delayed hypersensitivity skin test response, granulocyte function and sepsis in 2202 patients . Can J Surg . 1985;28:39-49. 2. Repine JE, Beehler CJ. Neutrophils and adult respiratory distress syndrome: two interlocking perspectives in 1991 . Am Rev Respir Dis . 1991; 144:251-252.Crossref 3. Holman JM Jr, Baba TM. Hepatocyte injury during post-operative sepsis: activated neutrophils as potential mediators . J Leukoc Biol . 1988;43: 193-203. 4. Weiss SJ. Tissue destruction by neutrophils . N Engl J Med . 1989;320: 365-376.Crossref 5. Martin TR, Pistorese BP, Hudson LD, Maunder RJ. The function of lung and blood neutrophils in patients with the adult respiratory distress syndrome: implications for the pathogenesis of lung infections . Am Rev Respir Dis . 1991;144:254-262.Crossref 6. Tellado JM, Christou NV. Critically anergic patients demonstrate polymorphonuclear neutrophil activation in the intravascular compartment with decreased cell delivery to inflammatory foci . J Leukoc Biol . 1991;50:547-553. 7. Tellado JM, Giannias B, Kapadia B, Chartrand L, de Santis M, Christou NV. Anergic patients before elective surgery have enhanced nonspecific host defence capacity . Arch Surg . 1990;125:49-53.Crossref 8. Tellado JM, Christou NV. In vitro polymorphonuclear neutrophil function in surgical patients does not correlate with anergy but with activating processes such as sepsis and trauma . Surgery . 1989;106:718-722. 9. Jaffe EA. Culture and identification of large vessel endothelial cells . In: Hudson LD, ed. Biology of Endothelial Cells . The Hague, The Netherlands: Martinus Nijhoff Publishers; 1984:92-108. 10. Jaffe EA, Nachman RL, Becker CC, Minick CR. Culture of human endothelial cells derived from umbilical veins: identification by morphologic and immunologic criteria . J Clin Invest . 1973;52:2745-2756.Crossref 11. Levin J, Poore TE, Zauber NP, Oser RS. Detection of endotoxin in the blood of patients with sepsis due to gram negative bacteria . N Engl J Med . 1970;283:1313-1316.Crossref 12. Arnaout MA. Structure and function of the leukocyte adhesion molecules CD11/CD18 . Blood . 1990;75:1037-1050. 13. Smith WC, Martin SD, Rotheiln R, Toman C, Anderson DC. Cooperative interactions of LFA-1 and Mac-1 wirth intracellular adhesion molecule-1 in faciliating adherence and transendothelial migration of human neutrophils in vitro . J Clin Invest . 1989;83:2008-2017.Crossref 14. Diamond MS, Staunton DE, de Fougerolles AR, Stacker SA. ICAM-1 (CD-54): a counter receptor for Mac-1 (CD11b/CD18) . J Cell Biol . 1990; 111:3129-3139.Crossref 15. Ward PA, Varani J. Mechanisms of neutrophil-mediated killing of endothelial cells . J Leukoc Biol . 1990;48:97-102. 16. Vandenbroucke-Grauls CMJE, Tjijssen HMWM, vanKessel KPM, et al. Injury to endothelial cells by phagocytosing polymorphonuclear leukocytes and modulatory role of lipoxygenase products . Infect Immun . 1987;55:1447-1451. 17. Follin P, Johansson A, Dahlgren C. Intracellular production of reactive oxygen species in human neutrophils following activation by the soluble stimuli FMLP, dioctanoy-1-glycerol and ionomycin . Cell Biochem Fund . 1991;9:29-37.Crossref 18. Geffner JR, Fontan PA, Sordelli DO, Isturiz MA. Neutrophil erythrotoxicity induced by phorbol myristate acetate: mechanisms involved in neutrophil activation . J Leukoc Biol . 1991;49:352-359. 19. Grisham MB, Everse J, Jansen H. Endotoxemia and neutrophil activation in vivo . Am J Physiol . 1988;254:H1017-H1022. 20. Forehand JR, Pabst MJ, Phillips WA, Johnston RB Jr. Lipopolysaccharide priming of human neutrophils for an enhanced respiratory burst: role of intracellular free calcium . J Clin Invest . 1989;83:74-83.Crossref 21. Teenenberg SD, Solomkin JS. Activation of neutrophils by cahectin/tumor necrosis factor: priming of N-formyl-methionyl-leucyl-phenylananine induced oxidative responsiveness via receptor mobilization without degranulation . J Leukoc Biol . 1990;47:217-223. 22. Fasano MB, Cousart S, Neal S, McCall CE. Increased expression of the interleukin-1 receptor on blood neutrophils of humans with the sepsis syndrome . J Clin Invest . 1991;88:1452-1459.Crossref 23. Aida Y, Pabst MJ. Neutrophil responses to lipopolysaccharide: effect of adherence on triggering and priming of the respiratory burst . J Immunol . 1991;146:1271-1276. 24. van Epps DE, Garcia L. Enhancement of neutrophil function as a result of prior exposure to chemotactic factor . J Clin Invest . 1980;66:167-175.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Polymorphonuclear Cell—Mediated Vascular Injury in Anergic Surgical Patients

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1993.01420130076012
Publisher site
See Article on Publisher Site

Abstract

Abstract • We examined the responses of primed polymorphonuclear neutrophils (PMNs) adhered to vascular endothelium, which can lead to endothelial cell damage as a mechanism of the capillary leak syndrome, the main cause of death in anergic patients. We tested PMNs from (1) preoperative reactive patients, (2) preoperative anergic patients, (3) anergic patients in the surgical intensive care unit, and (4) healthy controls for in vitro adherence and cytotoxicity on cultured human vein endothelial cells. Adherence of PMNs was 12.9%±3.9% in preoperative anergic patients and 13.1%±3.2% in anergic patients in the surgical intensive care unit compared with 9.0%±2.1% in preoperative reactive patients (P<.05). Cytotoxicity was 6.0%±2.8% in preoperative reactive patients, 13.7%±4.1% in preoperative anergic patients, and 14.3%±4.6% in anergic patients in the surgical intensive care unit. The PMNs from preoperative anergic patients were more cytotoxic against human vein endothelial cells when stimulated by Staphylococcus epidermidis or formyl-methionyleucylphenylalanine. We conclude that PMNs from anergic surgical patients adhere more to endothelial cells and can produce increased cytotoxicity that may lead to detrimental results. (Arch Surg. 1993;128:68-72) References 1. Christou NV. Host defense mechanisms in surgical patients: a correlative study of the delayed hypersensitivity skin test response, granulocyte function and sepsis in 2202 patients . Can J Surg . 1985;28:39-49. 2. Repine JE, Beehler CJ. Neutrophils and adult respiratory distress syndrome: two interlocking perspectives in 1991 . Am Rev Respir Dis . 1991; 144:251-252.Crossref 3. Holman JM Jr, Baba TM. Hepatocyte injury during post-operative sepsis: activated neutrophils as potential mediators . J Leukoc Biol . 1988;43: 193-203. 4. Weiss SJ. Tissue destruction by neutrophils . N Engl J Med . 1989;320: 365-376.Crossref 5. Martin TR, Pistorese BP, Hudson LD, Maunder RJ. The function of lung and blood neutrophils in patients with the adult respiratory distress syndrome: implications for the pathogenesis of lung infections . Am Rev Respir Dis . 1991;144:254-262.Crossref 6. Tellado JM, Christou NV. Critically anergic patients demonstrate polymorphonuclear neutrophil activation in the intravascular compartment with decreased cell delivery to inflammatory foci . J Leukoc Biol . 1991;50:547-553. 7. Tellado JM, Giannias B, Kapadia B, Chartrand L, de Santis M, Christou NV. Anergic patients before elective surgery have enhanced nonspecific host defence capacity . Arch Surg . 1990;125:49-53.Crossref 8. Tellado JM, Christou NV. In vitro polymorphonuclear neutrophil function in surgical patients does not correlate with anergy but with activating processes such as sepsis and trauma . Surgery . 1989;106:718-722. 9. Jaffe EA. Culture and identification of large vessel endothelial cells . In: Hudson LD, ed. Biology of Endothelial Cells . The Hague, The Netherlands: Martinus Nijhoff Publishers; 1984:92-108. 10. Jaffe EA, Nachman RL, Becker CC, Minick CR. Culture of human endothelial cells derived from umbilical veins: identification by morphologic and immunologic criteria . J Clin Invest . 1973;52:2745-2756.Crossref 11. Levin J, Poore TE, Zauber NP, Oser RS. Detection of endotoxin in the blood of patients with sepsis due to gram negative bacteria . N Engl J Med . 1970;283:1313-1316.Crossref 12. Arnaout MA. Structure and function of the leukocyte adhesion molecules CD11/CD18 . Blood . 1990;75:1037-1050. 13. Smith WC, Martin SD, Rotheiln R, Toman C, Anderson DC. Cooperative interactions of LFA-1 and Mac-1 wirth intracellular adhesion molecule-1 in faciliating adherence and transendothelial migration of human neutrophils in vitro . J Clin Invest . 1989;83:2008-2017.Crossref 14. Diamond MS, Staunton DE, de Fougerolles AR, Stacker SA. ICAM-1 (CD-54): a counter receptor for Mac-1 (CD11b/CD18) . J Cell Biol . 1990; 111:3129-3139.Crossref 15. Ward PA, Varani J. Mechanisms of neutrophil-mediated killing of endothelial cells . J Leukoc Biol . 1990;48:97-102. 16. Vandenbroucke-Grauls CMJE, Tjijssen HMWM, vanKessel KPM, et al. Injury to endothelial cells by phagocytosing polymorphonuclear leukocytes and modulatory role of lipoxygenase products . Infect Immun . 1987;55:1447-1451. 17. Follin P, Johansson A, Dahlgren C. Intracellular production of reactive oxygen species in human neutrophils following activation by the soluble stimuli FMLP, dioctanoy-1-glycerol and ionomycin . Cell Biochem Fund . 1991;9:29-37.Crossref 18. Geffner JR, Fontan PA, Sordelli DO, Isturiz MA. Neutrophil erythrotoxicity induced by phorbol myristate acetate: mechanisms involved in neutrophil activation . J Leukoc Biol . 1991;49:352-359. 19. Grisham MB, Everse J, Jansen H. Endotoxemia and neutrophil activation in vivo . Am J Physiol . 1988;254:H1017-H1022. 20. Forehand JR, Pabst MJ, Phillips WA, Johnston RB Jr. Lipopolysaccharide priming of human neutrophils for an enhanced respiratory burst: role of intracellular free calcium . J Clin Invest . 1989;83:74-83.Crossref 21. Teenenberg SD, Solomkin JS. Activation of neutrophils by cahectin/tumor necrosis factor: priming of N-formyl-methionyl-leucyl-phenylananine induced oxidative responsiveness via receptor mobilization without degranulation . J Leukoc Biol . 1990;47:217-223. 22. Fasano MB, Cousart S, Neal S, McCall CE. Increased expression of the interleukin-1 receptor on blood neutrophils of humans with the sepsis syndrome . J Clin Invest . 1991;88:1452-1459.Crossref 23. Aida Y, Pabst MJ. Neutrophil responses to lipopolysaccharide: effect of adherence on triggering and priming of the respiratory burst . J Immunol . 1991;146:1271-1276. 24. van Epps DE, Garcia L. Enhancement of neutrophil function as a result of prior exposure to chemotactic factor . J Clin Invest . 1980;66:167-175.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1993

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