The regulation of neutrophil activation and adhesion during femorodistal bypass surgery.
OBJECTIVE
To determine the effect that revascularising chronic critically ischaemic legs has no neutrophil activation and adhesion.


METHODS
Prospective clinical study.


METHODS
University Hospital.


METHODS
Twenty-five patients, 16 men and nine women undergoing femorodistal surgery.


METHODS
Venous blood assays for neutrophils expression of CD11b, neutrophil adhesion, and the plasma concentration of the shed endothelial adhesion receptor, soluble intracellular adhesion molecule 1 (sICAM-1). Urinary microalbuminaemia was measured and expressed as an albumin/creatinine ratio (ACR), as a marker of vascular permeability and plasma neutrophil elastase as evidence of neutrophil activation. Venous blood was taken preoperatively, during surgery and for the first 7 days postoperatively.


RESULTS
Neutrophil CD11b expression fell following reperfusion of the limb (21.4 mcf to 9.7 mcf, p < 0.02 Mann Whitney U-test) as did neutrophil adhesion (preop. 75% adhesion, postop. 28% p < 0.01). However, the plasma elastase levels rose from 95 micrograms/l to 345 micrograms/l at 4 h and the ACR increased from 5.3 mg/ml to 304.2 mg/ml. The concentration of sICAM-1 fell following reperfusion (p < 0.04).


CONCLUSIONS
The change in CD11b, sICAM-1 and adhesion may represent a normal immunological response to ischaemia/reperfusion.
Spark
J I
JI
Department of Vascular, St. James's University Hospital, Leeds, U.K.
Chetter
I C
IC
Kester
R C
RC
Guillou
P J
PJ
Scott
D J
DJ
D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000652:urine; D000704:Analysis of Variance; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D018845:CD11 Antigens / Q000097:blood; D002448:Cell Adhesion; D003404:Creatinine / Q000652:urine; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation; D009504:Neutrophils / Q000201:enzymology / Q000502:physiology*; D011446:Prospective Studies
D018845:CD11 Antigens; D018799:Intercellular Adhesion Molecule-1; D003404:Creatinine; D019272:Leukocyte Elastase