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Ann Thorac Surg 1998;66:2135-2144
© 1998 The Society of Thoracic Surgeons
a Cardiothoracic Unit, Hammersmith Hospital, Imperial College School of Medicine, London, England, UK
Address reprint requests to Dr Taylor, Cardiothoracic Unit, Hammersmith Hospital, Imperial College School of Medicine, Du Cane Rd, London W12 0NN, England
During the inflammatory response, triggered by cardiopulmonary bypass, interaction between activated leukocytes, platelets, and endothelial cells is mediated through the expression of three main groups of adhesion molecules: the selectins, the integrins, and the immunoglobulin superfamily. The selectins, which mediate the initial rolling of the leukocyte on the endothelium, are divided in three subgroups: L-selectin is expressed on all three leukocyte types, P-selectin is expressed on platelets and endothelial cells, and E-selectin is only expressed on endothelial cells. Integrins can be found on most cell types, consist of an 
and a ß subunit and mediate firm adhesion of the leukocyte and migration into the tissues. They are classified into subgroups according to the type of their ß subunit. Immunoglobulins such as ICAM-1 and VCAM-1 are expressed mainly on endothelium and act as ligands for certain integrins. This review article summarizes the existing, and rapidly expanding, literature concerning the effects of cardiopulmonary bypass on the expression of leukocyte and endothelial adhesion molecules. Deeper understanding of the behavior and the role of adhesion molecules during cardiopulmonary bypass may facilitate effective intervention in the inflammatory response process and suppression of its adverse effects.
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