| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1993;55:619-624
© 1993 The Society of Thoracic Surgeons
a Department of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
b Division of Immunology, Department of Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
c Division of Cardiology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
d T Cell Sciences Inc, Cambridge, Massachusetts, USA
Accepted for publication June 15, 1992.
* Address reprint requests to Dr Cameron, The Johns Hopkins Hospital, 600 N Wolfe St, Blalock 618, Baltimore, MD 21205.
Although complement activation during cardiopulmonary bypass (CPB) is well documented, its pathogenic role in postperfusion organ injury is unproven. In this study, soluble human complement receptor type 1 (sCR1), a potent inhibitor of complement activation, was used to determine the contribution of complement activation to pulmonary injury in a porcine model of CPB. In vitro experiments demonstrated that sCR1 inhibits both classic and alternative complement pathways in the pig. Seven control piglets and 6 piglets treated with sCR1 (12 mg/kg intravenously) underwent 2 hours of hypothermic (28 °C) CPB followed by 2 hours of observation. In control piglets, total hemolytic complement activity and functional activities of C3 and C5 declined to 61.3%, 67.8%, and 61.4% of prebypass values, respectively, after 2 hours of CPB. Plasma from animals treated with sCR1 had virtually no hemolytic activity (total hemolytic complement activity < 5% of baseline), demonstrating effective complement inhibition. Similar degrees of neutropenia developed in the two groups during CPB, and there was no difference in post-CPB lung tissue myeloperoxidase level. Two hours after CPB, pulmonary vascular resistance increased 338% in control piglets but only 147% in piglets pretreated with sCR1 (p < 0.05); the alveolar-arterial gradient was not significantly different between controls (331 ± 52 mm Hg) and piglets receiving sCR1 (290 ± 85 mm Hg), Histologic examination revealed similar degrees of pulmonary edema in both groups. These data constitute direct evidence that complement activation plays a pathogenic role in lung injury after CPB. Although pretreatment with sCR1 ameliorated lung injury after CPB, resulting in decreased pulmonary hypertension, complement inhibition did not improve post-CPB oxygenation and had no significant effect on leukocyte kinetics or lung histology. Thus, complement participates in the pathogenesis of lung injury after CPB, but is not responsible for all of the pulmonary damage.
This article has been cited by other articles:
|
|
 |
|
  R. J. De Silva, A. Vuylsteke, S. J. Fritchley, A. K. Trull, J. J. Dunning, and J. Wallwork APT070 inhibits complement activation during in vitro cardiopulmonary bypass Eur J Cardiothorac Surg, July 1, 2006; 30(1): 72 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. P. Schurr, G. Zund, S. P. Hoerstrup, J. Grunenfelder, F. E. Maly, P. R. Vogt, and M. I. Turina Preoperative administration of steroids: influence on adhesion molecules and cytokines after cardiopulmonary bypass Ann. Thorac. Surg., October 1, 2001; 72(4): 1316 - 1320. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. D. Riley, H. Sato, Z.-Q. Zhao, V. H. Thourani, J. E. Jordan, A. X. Fernandez, X.-L. Ma, D. R. Hite, D. F. Rigel, T. C. Pellas, et al. Recombinant human complement C5a receptor antagonist reduces infarct size after surgical revascularization J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 350 - 358. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Grunenfelder, G. Zund, A. Schoeberlein, E. R. Schmid, U. Schurr, R. Frisullo, F. Maly, and M. Turina Expression of adhesion molecules and cytokines after coronary artery bypass grafting during normothermic and hypothermic cardiac arrest Eur J Cardiothorac Surg, June 1, 2000; 17(6): 723 - 728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tofukuji, G. L. Stahl, C. Metais, M. Tomita, A. Agah, C. Bianchi, M. P. Fink, and F. W. Sellke Mesenteric dysfunction after cardiopulmonary bypass: role of complement C5a Ann. Thorac. Surg., March 1, 2000; 69(3): 799 - 807. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. Chai, R. Nassar, A. E. Oakeley, D. M. Craig, G. Quick Jr, J. Jaggers, S. P. Sanders, R. M. Ungerleider, and P. A. W. Anderson Soluble Complement Receptor-1 Protects Heart, Lung, and Cardiac Myofilament Function From Cardiopulmonary Bypass Damage Circulation, February 8, 2000; 101(5): 541 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Lazar, Y. Bao, J. Gaudiani, S. Rivers, and H. Marsh Total Complement Inhibition : An Effective Strategy to Limit Ischemic Injury During Coronary Revascularization on Cardiopulmonary Bypass Circulation, September 28, 1999; 100(13): 1438 - 1442. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Asimakopoulos, P. L.C. Smith, C. P. Ratnatunga, and K. M. Taylor Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass Ann. Thorac. Surg., September 1, 1999; 68(3): 1107 - 1115. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Jordan, Z.-Q. Zhao, and J. Vinten-Johansen The role of neutrophils in myocardial ischemia-reperfusion injury Cardiovasc Res, September 1, 1999; 43(4): 860 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. W. Park, M. Tofukuji, C. Metais, M. E. Comunale, H. B. Dai, M. Simons, G. L. Stahl, A. Agah, and F. W. Sellke Attenuation of Endothelium-Dependent Dilation of Pig Pulmonary Arterioles After Cardiopulmonary Bypass Is Prevented by Monoclonal Antibody to Complement C5a Anesth. Analg., July 1, 1999; 89(1): 42 - 42. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Picone, C. J. Lutz, C. Finck, D. Carney, L. A. Gatto, A. Paskanik, B. Searles, K. Snyder, and G. Nieman Multiple sequential insults cause post-pump syndrome Ann. Thorac. Surg., April 1, 1999; 67(4): 978 - 985. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Nilsson, R. Larsson, J. Hong, G. Elgue, K. N. Ekdahl, A. Sahu, and J. D. Lambris Compstatin Inhibits Complement and Cellular Activation in Whole Blood in Two Models of Extracorporeal Circulation Blood, September 1, 1998; 92(5): 1661 - 1667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Schmid, A. Zollinger, T. Singer, S. Hillinger, J. R. Leon-Wyss, O. M. Schob, K. Hogasen, G. Zund, G. A. Patterson, and W. Weder Effect of soluble complement receptor type 1 on reperfusion edema and neutrophil migration after lung allotransplantation in swine J. Thorac. Cardiovasc. Surg., July 1, 1998; 116(1): 90 - 94. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. Nordang, C. Laurent, and T. E. Mollnes Complement Activation in Sudden Deafness Arch Otolaryngol Head Neck Surg, June 1, 1998; 124(6): 633 - 636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Lazar, T. Hamasaki, Y. Bao, S. Rivers, S. A. Bernard, and R. J. Shemin Soluble Complement Receptor Type I Limits Damage During Revascularization of Ischemic Myocardium Ann. Thorac. Surg., April 1, 1998; 65(4): 973 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Makrides Therapeutic Inhibition of the Complement System Pharmacol. Rev., March 1, 1998; 50(1): 59 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Moen, K. Hogasen, E. Fosse, E. Dregelid, V. Brockmeier, P. Venge, M. Harboe, and T. E. Mollnes Attenuation of Changes in Leukocyte Surface Markers and Complement Activation With Heparin-Coated Cardiopulmonary Bypass Ann. Thorac. Surg., January 1, 1997; 63(1): 105 - 111. [Abstract] [Full Text]
|
|
|
|
|
|
A. Finn, B. P. Morgan, N. Rebuck, N. Klein, C. A. Rogers, M. Hibbs, M. Elliott, D. F. Shore, T. W. Evans, S. Strobel, et al. EFFECTS OF INHIBITION OF COMPLEMENT ACTIVATION USING RECOMBINANT SOLUBLE COMPLEMENT RECEPTOR 1 ON NEUTROPHIL CD11B/CD18 AND L-SELECTIN EXPRESSION AND RELEASE OF INTERLEUKIN-8 AND ELASTASE IN SIMULATED CARDIOPULMONARY BYPASS J. Thorac. Cardiovasc. Surg., February 1, 1996; 111(2): 451 - 459. [Abstract] [Full Text]
|
|
|
|
 |
|
 P. Hornick and A. George Blood contact activation: pathophysiological effects and therapeutic approaches Perfusion, January 1, 1996; 11(1): 3 - 19. [PDF]
|
|
|
|
|
|
E. Ovrum, T. E. Mollnes, E. Fosse, E. Am Holen, G. Tangen, M.-A. L. Ringdal, and V. Videm High and low heparin dose with heparin-coated cardiopulmonary bypass: Activation of complement and granulocytes Ann. Thorac. Surg., December 1, 1995; 60(6): 1755 - 1761. [Abstract] [PDF]
|
|
|
|
|
|
O. Moen, E. Fosse, V. Brockmeier, C. Andersson, T. E. Mollnes, K. Hogsen, and P. Venge Disparity in blood activation by two different heparin-coated cardiopulmonary bypass systems Ann. Thorac. Surg., November 1, 1995; 60(5): 1317 - 1323. [Abstract] [PDF]
|
|
|
|
|
|
L. H. Edmunds Jr Surface-bound heparin--Panacea or peril? Ann. Thorac. Surg., August 1, 1994; 58(2): 285 - 286. [PDF]
|
|
|
|
|
|
M. Pekna, L. Hagman, E. Halden, U. R. Nilsson, B. Nilsson, and S. Thelin Complement activation during cardiopulmonary bypass: Effects of immobilized heparin Ann. Thorac. Surg., August 1, 1994; 58(2): 421 - 424. [Abstract] [PDF]
|
|
|
|
|
|
A. M. Gillinov, J. A. Winkelstein, A. Herskowitz, and D. E. Cameron Reply Ann. Thorac. Surg., March 1, 1994; 57(3): 782 - 782. [PDF]
|
|
|
|
|
|
P. Mastroroberto, M. Chello, and A. R. Marchese Plasma C3a and C5a concentrations during cardiopulmonary bypass Ann. Thorac. Surg., March 1, 1994; 57(3): 781 - 782. [PDF]
|
|
|
|
|
|
A. M. Gillinov, J. M. Redmond, J. A. Winkelstein, K. J. Zehr, A. Herskowitz, W. A. Baumgartner, and D. E. Cameron Complement and neutrophil activation during cardiopulmonary bypass: A study in the complement-deficient dog Ann. Thorac. Surg., February 1, 1994; 57(2): 345 - 352. [Abstract] [PDF]
|
|
|
|
|
|
A. M. Gillinov, J. M. Bator, K. J. Zehr, J. M. Redmond, R. M. Burch, C. Ko, J. A. Winkelstein, R. S. Stuart, W. A. Baumgartner, and D. E. Cameron Neutrophil adhesion molecule expression during cardiopulmonary bypass with bubble and membrane oxygenators Ann. Thorac. Surg., October 1, 1993; 56(4): 847 - 853. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
