Neutrophil adhesion to vascular prosthetic surfaces triggers nonapoptotic cell death.
OBJECTIVE
To test the hypothesis that neutrophil adhesion to expanded polytetrafluoroethylene (ePTFE) and Dacron triggers cell death.


BACKGROUND
Vascular prosthetic infections are intransigent clinical dilemmas associated with excessive rates of death and complications. Impaired neutrophil function has been implicated in the infection of implanted cardiovascular devices. ePTFE and Dacron are potent neutrophil stimuli able to elicit activation responses such as reactive oxygen species production independent of exogenous/soluble agonists. Reactive oxygen species that are released into the medium when neutrophils are challenged by soluble agonists are known to cause self-destruction. The authors therefore sought to examine whether neutrophil adhesion to prosthetic graft materials decreases neutrophil viability by means of reactive oxygen species production.


METHODS
Neutrophils were adhered to surfaces for up to 6 hours. Cell viability was monitored with propidium iodide staining and lactate dehydrogenase release.


RESULTS
Within 6 hours of adhesion to ePTFE and Dacron, respectively, 59% +/- 11% and 44% +/- 5% (n = 7) of the neutrophils were stained by propidium iodide. Indistinguishable results were obtained with plasma-coated ePTFE and Dacron. In contrast, less than 2% of the neutrophils adherent to fibrinogen-, immunoglobin-, or fetal bovine serum-coated polystyrene surfaces for 6 hours were positive for propidium iodide. The increase in membrane permeability to propidium iodide was accompanied by a two- to threefold increase in lactate dehydrogenase release. Pretreatment of neutrophils with N-acetyl-L-cysteine, cytochalasin D, or cyclosporin A significantly reduced the number of propidium iodide-positive ePTFE and Dacron adherent neutrophils.


CONCLUSIONS
Neutrophil adhesion to ePTFE and Dacron triggers a rapid nonapoptotic cell death. The effect of ePTFE and Dacron on neutrophil viability appears to be caused by reactive oxygen species production. The premature death of graft-adherent neutrophils provides a novel explanation of the defect in neutrophil bacterial killing associated with vascular prosthetic grafts.
Nadzam
G S
GS
Department of Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
De La Cruz
C
C
Greco
R S
RS
Haimovich
B
B
D001807:Blood Vessel Prosthesis; D002448:Cell Adhesion; D016923:Cell Death / Q000502:physiology; D002470:Cell Survival; D015638:Cytochalasin D / Q000494:pharmacology; D006801:Humans; D009504:Neutrophils / Q000502:physiology*; D019384:Nucleic Acid Synthesis Inhibitors / Q000494:pharmacology; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D017382:Reactive Oxygen Species / Q000378:metabolism
D019384:Nucleic Acid Synthesis Inhibitors; D011093:Polyethylene Terephthalates; D017382:Reactive Oxygen Species; D015638:Cytochalasin D; D011138:Polytetrafluoroethylene