Leukocytes mediate acid aspiration-induced multiorgan edema.
BACKGROUND
Acid aspiration leads to lung injury characterized by polymorphonuclear neutrophil leukocytes (PMN) sequestration and edema. This study investigates whether localized acid aspiration leads to activation of circulating PMN and triggers both local and remote PMN sequestration and whether these cells are responsible for increase in pulmonary permeability and systemic organ edema.


METHODS
Rats pretreated with intravenous saline solution or rendered neutropenic (nitrogen mustard or antineutrophil serum) underwent tracheostomy and insertion of a cannula into a lung segment. This was followed by instillation of either 0.1 N HCl or saline solution.


RESULTS
After 30 minutes leukopenia was noted (2650 white blood cells/mm3) in saline-treated, acid-lavaged rats, and circulating PMN produced H2O2 (20 femtomole dichlorofluorescein/PMN compared with 3 femtomole in control animals (both, p < 0.05). PMN were progressively sequestered in the nonaspirated lung, the heart, and kidney. Permeability and edema developed in the lungs and systemic organs. In neutropenic rats there was a reduction of aspiration-induced thromboxane B2 and leukotriene B4 synthesis (p < 0.05), decrease in lung wet to dry weight and protein level in bronchoalveolar lavage of the aspirated and nonaspirated lungs, and reduction in myeloperoxidase activity in the heart and kidney and in wet to dry weight of these organs (all, p < 0.05).


CONCLUSIONS
These data indicate that localized acid aspiration activates circulating neutrophils and promotes their sequestration in the lungs and systemic organs. These cells are largely responsible for the multisystem organ edema.
Goldman
G
G
Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115.
Welbourn
R
R
Klausner
J M
JM
Kobzik
L
L
Valeri
C R
CR
Shepro
D
D
Hechtman
H B
HB
D000818:Animals; D004487:Edema / Q000209:etiology*; D006851:Hydrochloric Acid; D006861:Hydrogen Peroxide / Q000378:metabolism; D007668:Kidney / Q000201:enzymology; D007970:Leukopenia / Q000139:chemically induced / Q000473:pathology; D008168:Lung / Q000473:pathology; D008297:Male; D008466:Mechlorethamine; D009206:Myocardium / Q000201:enzymology; D009504:Neutrophils / Q000378:metabolism / Q000473:pathology / Q000502:physiology*; D009195:Peroxidase / Q000378:metabolism; D011015:Pneumonia, Aspiration / Q000150:complications* / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D013929:Thromboxane B2 / Q000097:blood
D008466:Mechlorethamine; D013929:Thromboxane B2; D006861:Hydrogen Peroxide; D009195:Peroxidase; D006851:Hydrochloric Acid