This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Tang, M Articles by Chen, C Z Search for Related Content PubMed PubMed Citation Articles by Tang, M Articles by Chen, C Z Social Bookmarking                         What's this?

Effect of cardiopulmonary bypass on leukocyte activation: changes in membrane-bound elastase on neutrophils

Department of Cardiothoracic Surgery, Ren Ji Hospital affiliated to Shanghai Second Medical University, Shanghai, China

Y J Gu

University Medical Center Groningen, Groningen, The Netherlands

W J Wang

Department of Cardiothoracic Surgery, Ren Ji Hospital affiliated to Shanghai Second Medical University, Shanghai, China

Y P Xu

Center of Molecular Biology and Department of Respiratory Disease, Ren Ji Hospital affiliated to Shanghai Second Medical University, Shanghai, China

C Z Chen

Department of Cardiothoracic Surgery, Ren Ji Hospital affiliated to Shanghai Second Medical University, Shanghai, China, Changzhi6{at}hotmail.com

Background: Neutrophil elastase is known to be released from the activated leukocytes as a result of cardiopulmonary bypass (CPB). However, its biological effect on organ injury is questionable because it is quickly bound by natural proteinase inhibitors (PIs). Recently, membrane-bound elastase (MBE) was found to be able to resist the PIs’ process and, thus, is biologically more active. This paper studies the effect of CPB on the kinetic change of MBE and its possible link to postoperative inflammation and organ function.

Method: Ten consecutive patients undergoing elective coronary artery bypass grafting (CABG) surgery with CPB were recruited into the study. Blood samples were taken before sternotomy, after aortic declamping, at the end of CPB, three and six hours after CPB and on the first postoperative day. MBE was determined by substrate assay from isolated neutrophils. Inflammation and organ function markers were determined according to routine laboratory methods.

Results: MBE slightly increased after aortic declamping, while it significantly increased and reached its peak at the end of CPB; it returned to its preoperative level on the first postoperative day. In contrast to lung sequestration of neutrophils, there was no transpulmonary gradient of MBE between left and right atria after aortic declamping. Neither MBE nor total MBE activity was positively correlated with postoperative inflammation markers such as blood lactate and C-reactive protein and organ function markers such as creatine phosphokinase and alanine aminotransferase.

Conclusions: CPB induces increased MBE expression on neutrophils with its peak at the end of CPB. Lack of association between neutrophil MBE and clinical markers suggests that multiple systems might be involved in the post-CPB inflammatory reaction and organ dysfunction.

Perfusion, Vol. 19, No. 2, 93-99 (2004)
DOI: 10.1191/0267659104pf727oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				O. M. Bical, Y. Fromes, D. Gaillard, M. Fischer, O. Ponzio, P. Deleuze, M.-F. Gerhardt, and F. Trivin Comparison of the inflammatory response between miniaturized and standard CPB circuits in aortic valve surgery. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 699 - 702. [Abstract] [Full Text] [PDF]