Limits...
Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass.

Abdel-Rahman U, Margraf S, Aybek T, Lögters T, Bitu-Moreno J, Francischetti I, Kranert T, Grünwald F, Windolf J, Moritz A, Scholz M - J Inflamm (Lond) (2007)

Bottom Line: LIM prevented CPB-associated increase of neutrophil counts in peripheral blood.In group II, the CI was only slightly reduced (post: 3.86 +/- 0.49; pre 4.21 +/- 1.32 l/min/m2; p = 0.23).LIM appeared to accelerate the sequestration of hyperactivated neutrophils in the spleen and to reduce neutrophil infiltration of heart and lung.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Traumatology and Hand Surgery, Heinrich-Heine University, Düsseldorf, Germany. martin.scholz@uni-duesseldorf.de.

ABSTRACT

Background: The arterial in line application of the leukocyte inhibition module (LIM) in the cardiopulmonary bypass (CPB) limits overshooting leukocyte activity during cardiac surgery. We studied in a porcine model whether LIM may have beneficial effects on cardiac function after CPB.

Methods: German landrace pigs underwent CPB (60 min myocardial ischemia; 30 min reperfusion) without (group I; n = 6) or with LIM (group II; n = 6). The cardiac indices (CI) and cardiac function were analyzed pre and post CPB with a Swan-Ganz catheter and the cardiac function analyzer. Neutrophil labeling with technetium, scintigraphy, and histological analyses were done to track activated neutrophils within the organs.

Results: LIM prevented CPB-associated increase of neutrophil counts in peripheral blood. In group I, the CI significantly declined post CPB (post: 3.26 +/- 0.31; pre: 4.05 +/- 0.45 l/min/m2; p < 0.01). In group II, the CI was only slightly reduced (post: 3.86 +/- 0.49; pre 4.21 +/- 1.32 l/min/m2; p = 0.23). Post CPB, the intergroup difference showed significantly higher CI values in the LIM group (p < 0.05) which was in conjunction with higher pre-load independent endsystolic pressure volume relationship (ESPVR) values (group I: 1.57 +/- 0.18; group II: 1.93 +/- 0.16; p < 0.001). Moreover, the systemic vascular resistance and pulmonary vascular resistance were lower in the LIM group. LIM appeared to accelerate the sequestration of hyperactivated neutrophils in the spleen and to reduce neutrophil infiltration of heart and lung.

Conclusion: Our data provides strong evidence that LIM improves perioperative hemodynamics and cardiac function after CPB by limiting neutrophil activity and inducing accelerated sequestration of neutrophils in the spleen.

No MeSH data available.


Related in: MedlinePlus

Whole body scintigraphy pictures from an animal without LIM or with LIM following injection of HMPAO-labeled neutrophils (A). High radioactivity was found in the spleen of LIM-treated animals. An internal control with subcutanously injected E.coli (control pig with CPB) confirmed the neutrophil activity over time (B). Data for the accumulation of radioactivity in the myocardium and musle tissue of control and LIM-treated animals is shown (C) as mean ± SD (CPB: n = 7; CPB + LIM: n = 8).
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Figure 6: Whole body scintigraphy pictures from an animal without LIM or with LIM following injection of HMPAO-labeled neutrophils (A). High radioactivity was found in the spleen of LIM-treated animals. An internal control with subcutanously injected E.coli (control pig with CPB) confirmed the neutrophil activity over time (B). Data for the accumulation of radioactivity in the myocardium and musle tissue of control and LIM-treated animals is shown (C) as mean ± SD (CPB: n = 7; CPB + LIM: n = 8).

Mentions: In order to determine the global distribution of neutrophils within the body after passing the LIM, technetium-labeled neutrophils were injected into the blood circulation before onset of CPB or CPB with LIM (n = 2, each group). One hour after end of surgery the distribution of the labeled neutrophils was analyzed by scintigraphy (Figure 6). In Figure 6A an example for the total body distribution of radioactivity is provided. In contrast to the control animal the depicted scintigraphy of the LIM-treated animal revealed no or only little radioactive load in heart and lung, whereas the spleen was significantly loaded. As an internal control, attenuated E.coli were injected subcutaneously at six different intraoperative time points (onset of CPB and subsequently each 15 minutes) to provoke neutrophil migration to the injection site (Figure 6B). Black spots indicate that labeled neutrophils retained their ability to infiltrate the challenged tissues throughout the entire operation time. Radioactivity determined in biopsies from heart and muscle (reference tissue) revealed that LIM prevented CPB-mediated accumulation of labeled neutrophils in the heart (2.69 × 106 ± 1.19 and 4.30 ± 1.87 × 106/g, respectively). Data is shown in percent of the applied radioactivity (Figure 6C) as the mean ± SD (CPB: n = 7; CPB + LIM: n = 8).


Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass.

Abdel-Rahman U, Margraf S, Aybek T, Lögters T, Bitu-Moreno J, Francischetti I, Kranert T, Grünwald F, Windolf J, Moritz A, Scholz M - J Inflamm (Lond) (2007)

Whole body scintigraphy pictures from an animal without LIM or with LIM following injection of HMPAO-labeled neutrophils (A). High radioactivity was found in the spleen of LIM-treated animals. An internal control with subcutanously injected E.coli (control pig with CPB) confirmed the neutrophil activity over time (B). Data for the accumulation of radioactivity in the myocardium and musle tissue of control and LIM-treated animals is shown (C) as mean ± SD (CPB: n = 7; CPB + LIM: n = 8).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2100046&req=5

Figure 6: Whole body scintigraphy pictures from an animal without LIM or with LIM following injection of HMPAO-labeled neutrophils (A). High radioactivity was found in the spleen of LIM-treated animals. An internal control with subcutanously injected E.coli (control pig with CPB) confirmed the neutrophil activity over time (B). Data for the accumulation of radioactivity in the myocardium and musle tissue of control and LIM-treated animals is shown (C) as mean ± SD (CPB: n = 7; CPB + LIM: n = 8).
Mentions: In order to determine the global distribution of neutrophils within the body after passing the LIM, technetium-labeled neutrophils were injected into the blood circulation before onset of CPB or CPB with LIM (n = 2, each group). One hour after end of surgery the distribution of the labeled neutrophils was analyzed by scintigraphy (Figure 6). In Figure 6A an example for the total body distribution of radioactivity is provided. In contrast to the control animal the depicted scintigraphy of the LIM-treated animal revealed no or only little radioactive load in heart and lung, whereas the spleen was significantly loaded. As an internal control, attenuated E.coli were injected subcutaneously at six different intraoperative time points (onset of CPB and subsequently each 15 minutes) to provoke neutrophil migration to the injection site (Figure 6B). Black spots indicate that labeled neutrophils retained their ability to infiltrate the challenged tissues throughout the entire operation time. Radioactivity determined in biopsies from heart and muscle (reference tissue) revealed that LIM prevented CPB-mediated accumulation of labeled neutrophils in the heart (2.69 × 106 ± 1.19 and 4.30 ± 1.87 × 106/g, respectively). Data is shown in percent of the applied radioactivity (Figure 6C) as the mean ± SD (CPB: n = 7; CPB + LIM: n = 8).

Bottom Line: LIM prevented CPB-associated increase of neutrophil counts in peripheral blood.In group II, the CI was only slightly reduced (post: 3.86 +/- 0.49; pre 4.21 +/- 1.32 l/min/m2; p = 0.23).LIM appeared to accelerate the sequestration of hyperactivated neutrophils in the spleen and to reduce neutrophil infiltration of heart and lung.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Traumatology and Hand Surgery, Heinrich-Heine University, Düsseldorf, Germany. martin.scholz@uni-duesseldorf.de.

ABSTRACT

Background: The arterial in line application of the leukocyte inhibition module (LIM) in the cardiopulmonary bypass (CPB) limits overshooting leukocyte activity during cardiac surgery. We studied in a porcine model whether LIM may have beneficial effects on cardiac function after CPB.

Methods: German landrace pigs underwent CPB (60 min myocardial ischemia; 30 min reperfusion) without (group I; n = 6) or with LIM (group II; n = 6). The cardiac indices (CI) and cardiac function were analyzed pre and post CPB with a Swan-Ganz catheter and the cardiac function analyzer. Neutrophil labeling with technetium, scintigraphy, and histological analyses were done to track activated neutrophils within the organs.

Results: LIM prevented CPB-associated increase of neutrophil counts in peripheral blood. In group I, the CI significantly declined post CPB (post: 3.26 +/- 0.31; pre: 4.05 +/- 0.45 l/min/m2; p < 0.01). In group II, the CI was only slightly reduced (post: 3.86 +/- 0.49; pre 4.21 +/- 1.32 l/min/m2; p = 0.23). Post CPB, the intergroup difference showed significantly higher CI values in the LIM group (p < 0.05) which was in conjunction with higher pre-load independent endsystolic pressure volume relationship (ESPVR) values (group I: 1.57 +/- 0.18; group II: 1.93 +/- 0.16; p < 0.001). Moreover, the systemic vascular resistance and pulmonary vascular resistance were lower in the LIM group. LIM appeared to accelerate the sequestration of hyperactivated neutrophils in the spleen and to reduce neutrophil infiltration of heart and lung.

Conclusion: Our data provides strong evidence that LIM improves perioperative hemodynamics and cardiac function after CPB by limiting neutrophil activity and inducing accelerated sequestration of neutrophils in the spleen.

No MeSH data available.


Related in: MedlinePlus