Kinetics of P-selectin expression in regional vascular beds after resuscitation of hemorrhagic shock: a clue to the mechanism of multiple system organ failure.
Leukocyte-endothelial cell interactions play an important role in mediating organ dysfunctions observed after hemorrhagic shock. P-selectin is the first endothelial cell adhesion molecule to be upregulated after an ischemic insult. The objective of this study was to define kinetics of P-selectin expression in different regional vascular beds of mice exposed to hemorrhagic shock. In-vivo P-selectin expressions were determined using dual radiolabeled monoclonal antibody technique in lungs, heart, liver, kidneys, intestinal mesentery, stomach, small bowel, and colon 0.5, 1, 2, 5, 10, and 24 h after resuscitation of 40 mmHg hemorrhagic shock. In another group, P-selectin expression was determined in same organs 5 h after resuscitation of 30 mmHg hemorrhagic shock. Hemorrhagic shock of 40 mmHg caused significant upregulation of P-selectin in lungs and liver at 30 min after resuscitation (P < 0.001). There was a second and more pronounced upregulation of P-selectin in lungs and liver at 5 h after resuscitation (P < 0.001). In heart, intestinal mesentery, stomach, small bowel, and colon, P-selectin was not upregulated until 5 h after resuscitation from 40 mmHg hemorrhagic shock (P < 0.001). While hemorrhagic shock of 40 mmHg did not cause P-selectin upregulation in kidneys, hemorrhage to 30 mmHg did elicit a significant increase at 5 h after resuscitation (P < 0.001). We conclude that P-selectin is upregulated after resuscitation of hemorrhagic shock in lungs, liver, heart, stomach, and intestines. P-selectin upregulation in kidneys only takes place after more severe hemorrhagic shock.
Akgür
F M
FM
Department of Pediatric Surgery, Dokuz Eylül University, School of Medicine, Izmir, Turkey.
Zibari
G B
GB
McDonald
J C
JC
Granger
D N
DN
Brown
M F
MF
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D003106:Colon / Q000098:blood supply / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism*; D005753:Gastric Mucosa / Q000378:metabolism; D007421:Intestine, Small / Q000098:blood supply / Q000378:metabolism; D007668:Kidney / Q000098:blood supply / Q000378:metabolism; D008099:Liver / Q000098:blood supply / Q000378:metabolism; D008168:Lung / Q000098:blood supply / Q000378:metabolism; D008643:Mesentery / Q000098:blood supply / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL; D008833:Microcirculation / Q000378:metabolism*; D009102:Multiple Organ Failure / Q000209:etiology / Q000378:metabolism*; D009206:Myocardium / Q000378:metabolism; D019007:P-Selectin / Q000096:biosynthesis*; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D013270:Stomach / Q000098:blood supply; D015854:Up-Regulation
D019007:P-Selectin