Hydroxyethyl starch reduces the chemotaxis of white cells through endothelial cell monolayers.
BACKGROUND
Polymorphonuclear leukocytes (PMNs) play a tremendous role during inflammatory processes. PMNs have to pass a monolayer of endothelial cells to migrate into the extravascular space. Hydroxyethyl starch (HES) is frequently used as a volume expander in critically ill patients.


METHODS
The aim of this study was to investigate whether HES influences the chemotaxis of PMNs through endothelial cell monolayers by using a test system that allows the simultaneous treatment of both cell types. Human umbilical endothelial cells were cultured on microporous membrane filters. PMNs were isolated and PMN chemotaxis was studied.


RESULTS
The number of untreated PMNs that migrated through untreated endothelial cell monolayers in response to a chemoattractant was used as a control and set as 100 percent. In clinically relevant concentrations, HES was able to significantly decrease PMN chemotaxis through endothelial cell monolayers, showing a dose-dependent effect (0.1 mg/mL: 99.6 +/- 10.9%, p = NS compared to control; 1 mg/mL: 82.4 +/- 8.3%, p<0.05 compared to control; 10 mg/mL: 62.9 +/- 11.7%, p<0.05). In this assay, both cell types (PMNs and endothelial cells in the monolayer) were treated simultaneously, which simulated the clinical situation after an intravenous injection of HES. The treatment of one cell type, PMNs (89.6 +/- 8.8%, p<0.05) or endothelial cells in the monolayer (76.2 +/- 9.4%, p<0.05), suggests that the influence on endothelial cells is greater.


CONCLUSIONS
HES is able to significantly reduce the chemotaxis of PMNs through endothelial cell monolayers. The possible clinical consequence of a moderate reduction in endothelium-mediated PMN chemotaxis in critically ill patients remains to be evaluated.
Hofbauer
R
R
Clinical Institute of Medical and Chemical Laboratory Diagnostics, the Department of Anesthesiology, University of Vienna, Austria.
Moser
D
D
Hornykewycz
S
S
Frass
M
M
Kapiotis
S
S
D000328:Adult; D002478:Cells, Cultured; D002634:Chemotaxis, Leukocyte / Q000187:drug effects*; D003864:Depression, Chemical; D004198:Disease Susceptibility; D004730:Endothelium, Vascular / Q000166:cytology*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000494:pharmacology*; D007239:Infections; D009504:Neutrophils / Q000187:drug effects* / Q000502:physiology; D010952:Plasma Substitutes / Q000009:adverse effects / Q000494:pharmacology*; D014471:Umbilical Veins
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes