Enhanced neutrophil migratory activity following major blunt trauma.
BACKGROUND
Neutrophil migration into the lung is a critical, but poorly understood step in the pathogenesis of post-traumatic, acute respiratory distress syndrome (ARDS). We investigated changes in interleukin-8 (IL-8) mediated neutrophil migration and associated changes in receptor expression, of the IL-8 receptors CXCR1, the integrins CD11b/CD18 and platelet endothelial cell adhesion molecule-1 (PECAM-1) in patients sustaining major trauma.


METHODS
Eleven patients with major trauma, injury severity score (ISS), median 22 (range 18-41), were followed prospectively. Eleven normal volunteers were used as controls. Blood samples were obtained within 4+/-2 h of injury, at 24 h, day 3 and day 5. Neutrophils migration was assessed by an in vitro IL-8 assay and neutrophil surface receptor expression by FACS analysis.


RESULTS
IL-8 mediated neutrophil migration was significantly increased on admission following major trauma and remained elevated for 3 days (p<0.05). This was associated with up-regulation of CXCR1 (p<0.01) and down-regulation of PECAM-1 (p<0.05). CD11b and CD18 although initially unchanged, became down-regulated on day 3 (p<0.05).


CONCLUSIONS
These data show that major trauma primes circulating neutrophils for increased migration in response to IL-8. This response is sustained for 72 h and is associated with changes in neutrophil surface receptor expression.
Bhatia
Raj K
RK
Department of Trauma & Orthopaedics, University Hospital for Wales, Heath Park, Cardiff, CF14 4XN, UK. raj1bhatia@hotmail.com
Pallister
Ian
I
Dent
Colin
C
Jones
Simon A
SA
Topley
Nicholas
N
D000328:Adult; D000368:Aged; D002465:Cell Movement / Q000502:physiology*; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D020556:Neutrophil Infiltration / Q000502:physiology; D009504:Neutrophils / Q000502:physiology*; D011956:Receptors, Cell Surface / Q000378:metabolism / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000473:pathology; D014949:Wounds, Nonpenetrating / Q000378:metabolism / Q000473:pathology*
D016209:Interleukin-8; D011956:Receptors, Cell Surface