Aprotinin reduces the expression of p-selectin on the surface of platelet and leukocyte-platelet conjugates.
P-Selectin, an adhesion molecule expressed on the surfaces of activated platelets and the vascular endothelium, mediates platelet binding to monocytes and neutrophils. Monocytes and neutrophils produce superoxide anion by activated platelets through p-selectin. Aprotinin, a serine protease inhibitor, inhibits plasmin to activate platelets during cardiopulmonary bypass (CPB). A total of 25 patients were studied to clarify the effects of aprotinin on p-selectin expression during CPB. Nine patients were not given aprotinin (control group), and 16 were given aprotinin of 2 million U in the priming solution (aprotinin group). The platelet count and soluble p-selectin in the plasma, p-selectin on the surface membranes of platelets, and leukocyte-platelet conjugate levels were measured during and after CPB. The platelet count was maintained well in the aprotinin group. The increases of soluble p-selectin in the plasma, platelet surface p-selectin, and leukocyte-platelet conjugates were less in the aprotinin group than in the control group (p < 0.05). In conclusion, aprotinin in patients undergoing CPB may reduce the early inflammatory reactions induced by p-selectin.
Inui
K
K
Second Department of Surgery, Yamagata University School of Medicine, Japan.
Shimazaki
Y
Y
Watanabe
T
T
Kuraoka
S
S
Uesho
K
K
Uchida
T
T
Shiono
S
S
D007611:Aprotinin / Q000494:pharmacology*; D001792:Blood Platelets / Q000378:metabolism*; D002315:Cardiopulmonary Bypass; D002448:Cell Adhesion; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology*
D019007:P-Selectin; D015842:Serine Proteinase Inhibitors; D007611:Aprotinin