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The Annals of Thoracic Surgery, Vol 53, 839-843, Copyright © 1992 by The Society of Thoracic Surgeons
YJ Gu, W van Oeveren, PW Boonstra, J de Haan and CR Wildevuur
The effects of cardiopulmonary bypass (CPB) on the expression of leukocyte
adhesive receptors, ie, complement receptor type 3 (CR3), were studied in
16 patients. The CR3 expression on leukocytes was determined by
time-resolved fluoroimmunoassay on a standardized number of cells isolated
from blood samples taken during various times during CPB. The results
demonstrated that CR3 expression on leukocytes increased immediately after
the start of CPB (p less than 0.05), concomitant with an early sharp
increase of plasma concentrations of C3a (p less than 0.01). After release
of the aortic cross-clamp, a second peak of leukocyte CR3 expression was
induced (p less than 0.05), paralleled by a significant increase of
leukotriene B4 (p less than 0.05) and elastase (p less than 0.05) levels in
the late period of CPB. In vitro studies with leukocytes isolated from
healthy donors (n = 5) showed a dose-dependent increase of CR3 expression
stimulated by zymosan-activated plasma, indicating that the rapid CR3
expression on leukocytes is likely mediated by complement activation.
However, the mechanisms for the second peak of leukocyte CR3 expression
during CPB remain to be further elucidated. In conclusion, CR3 expression
on leukocytes increased immediately after the start of CPB and was followed
by a second peak of expression in the late phase of CPB. Pharmacological
blockage of these adhesive receptors might reduce the leukocyte-mediated
deleterious effects of CPB.
ARTICLES
Leukocyte activation with increased expression of CR3 receptors during cardiopulmonary bypass
Thorax Centre, University Hospital Groningen, The Netherlands.
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