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Ann Thorac Surg 2000;69:1192-1197
© 2000 The Society of Thoracic Surgeons

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ORIGINAL ARTICLES: CARDIOVASCULAR

Leukocyte integrin expression in patients undergoing cardiopulmonary bypass

^a Cardiothoracic Unit at Hammersmith Hospital, National Heart and Lung Institute, Imperial College School of Medicine, London, England, United Kingdom
^b Cardiovascular Medicine Unit at Hammersmith Hospital, National Heart and Lung Institute, Imperial College School of Medicine, London, England, United Kingdom

Address reprint requests to Dr Taylor, Cardiothoracic Unit, Hammersmith Hospital, Imperial College School of Medicine, Du Cane Rd, London W12 0NN, England
e-mail: scarroll{at}rpms.ac.uk

Background. The recruitment of leukocytes to vascular endothelium is controlled by adhesion events mediated through the ß₂ integrins, whereas the response of extravasated leukocytes within the tissues is controlled through the ß₁ integrins. Although cardiopulmonary bypass (CPB) has been shown to be associated with a systemic inflammatory response and elevated levels of ß₂ integrins on leukocytes, its effect on the ß₁ integrins is not known. This study investigated the effect of the protease inhibitor aprotinin on the expression of the ß₁ and ß₂ integrins on circulating leukocytes in patients undergoing CPB.

Methods. Patients undergoing primary elective coronary artery bypass grafting were randomized into full-dose aprotinin or placebo groups. Blood samples were obtained at nine time points preoperatively, intraoperatively, and up to 6 days postoperatively. The surface expression of the ß₁ integrins VLA-1, -3, -4, -5, and -6 and of the ß₂ integrins CD11a/CD18, CD11b/CD18, and CD11c/CD18 was measured by flow cytometry on gated neutrophil and monocyte subpopulations in whole blood.

Results. Expression of the ß₁ integrins was not significantly altered during the study period and, therefore, aprotinin had no effect on the expression of these molecules. Of the ß₂ integrins, CD11b/CD18 expression was significantly increased on neutrophils at 15 minutes after onset of CPB in the placebo group (p < 0.01) but not in the aprotinin group.

Conclusions. This study showed that expression of the ß₁ integrins on neutrophils and monocytes did not alter during the first 6 days after CPB. Expression of the ß₂ integrin CD11b/CD18 increased significantly on neutrophils during CPB in control patients but not in patients treated with full-dose aprotinin.

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