Effect of synthetic colloids on major histocompatibility complex class II expression.
OBJECTIVE
Synthetic colloids are used for perioperative fluid management. We hypothesized that their use may be associated with changes in major histocompatibility complex (MHC) class II expression. This could affect patients' morbidity and mortality during clinical intervention.


METHODS
University research laboratory.


METHODS
Whole blood samples from healthy volunteers.


METHODS
Whole blood samples from healthy volunteers (n = 6) were incubated with different concentrations of hydroxyethyl starch (HES) from maize and potato (pHES), dextran, and polygelin (gelatine) for 24 hours with or without 100 U/mL human interferon gamma (IFN-gamma; stimulus for MHC class II expression). The expression of human leukocyte antigen (HLA): HLA-DR, HLA-DQ, and HLA-DP was detected simultaneously by a fluoresceinisothiocyanate (FITC)-labeled antibody and analyzed by flow cytometry on lymphocytes and monocytes.


RESULTS
Hydroxyethyl starch, pHES, and dextran induced a significant increase in HLA expression. The induction of MHC class II was independent of the structure (50 mg/mL: control, 8.7+/-1.4%; HES, 28 +/- 9.7%; pHES, 29.8 +/- 11.7%; and dextran, 50.2 +/- 8.1%). In contrast, polygelin increased HLA expression only at the highest concentration of gelatine (5 mg/mL, 7.8 +/- 1%; 50 mg/mL, 7.6 +/- 0.8%; 100 mg/mL, 7.3 +/- 1%; 200 mg/mL,16.2 +/- 2.3%). The addition of IFN-gamma decreased HLA expression in presence of highest concentration of HES and dextran.


CONCLUSIONS
In an ex vivo laboratory setting, we demonstrate that high concentrations of plasma expanders are associated with increased HLA expression on lymphocytes and monocytes. However, further in vivo studies are necessary to demonstrate the clinical significance of this observation.
Department of Anesthesiology and Intensive Care Medicine, Tuebingen University Hospital, 72076 Tuebingen, Germany. helene.haeberle@uni-tuebingen.de
Helene A
HA
Haeberle
Boris
B
Nohé
Holger K
HK
Eltzschig
Klaus
K
Unertl
Hans-Juergen
HJ
Dieterich
D003102:Colloids / Q000494:pharmacology*; D003911:Dextrans / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D005434:Flow Cytometry; D005455:Fluorescent Antibody Technique; D005780:Gelatin / Q000494:pharmacology; D015870:Gene Expression / Q000187:drug effects; D005802:Genes, MHC Class II / Q000235:genetics*; D006680:HLA Antigens / Q000096:biosynthesis; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology; D066298:In Vitro Techniques; D007371:Interferon-gamma / Q000494:pharmacology; D008214:Lymphocytes / Q000187:drug effects / Q000378:metabolism; D009000:Monocytes / Q000187:drug effects / Q000378:metabolism; D009997:Osmotic Pressure; D010952:Plasma Substitutes / Q000494:pharmacology; D011994:Recombinant Proteins; D012709:Serum Albumin / Q000378:metabolism; D013268:Stimulation, Chemical
D003102:Colloids; D003911:Dextrans; D006680:HLA Antigens; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D011994:Recombinant Proteins; D012709:Serum Albumin; D007371:Interferon-gamma; D005780:Gelatin