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The Annals of Thoracic Surgery, Vol 50, 597-601, Copyright © 1990 by The Society of Thoracic Surgeons
SD Tennenberg, CW Clardy, WW Bailey and JS Solomkin
Pulmonary dysfunction after cardiopulmonary bypass has been attributed to
the damaging effects of complement activation on the lung. To further
explore this phenomenon, we measured plasma levels of activated complement
components (radioimmunoassay), assessed neutrophil n-formyl-
methionyl-leucyl-phenylalanine (FMLP) receptor status (radioligand
saturation binding assay), and quantified pulmonary epithelial permeability
as radioaerosol lung clearance of technetium 99m-labeled diethylenetriamine
pentaacetic acid in a series of 8 patients undergoing cardiopulmonary
bypass. Significant elevations of plasma C3adesArg, C4adesArg, and
C5adesArg levels were seen just after CPB, indicating activation of both
the classic and alternate complement pathways. Neutrophil activation was
evident as increased expression of neutrophil FMLP surface receptors after
bypass. Despite the presence of complement and neutrophil activation,
increased pulmonary epithelial permeability was not seen. These data
support the hypothesis that complement and neutrophil activation during
cardiopulmonary bypass is not associated with acute lung injury, at least
not pulmonary epithelial injury. One can therefore infer that increased
pulmonary epithelial permeability in patients at high risk for and
experiencing sepsis-induced and trauma-induced adult respiratory distress
syndrome may be due to factors other than complement and neutrophil
activation.
ARTICLES
Complement activation and lung permeability during cardiopulmonary bypass
Department of Surgery, University of Cincinnati College of Medicine, Ohio.
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