Complement and leukocytes during cardiopulmonary bypass: effects on plasma C3d and C5a, leukocyte count, release of granulocyte elastase and granulocyte chemotaxis.
In an effort to further elucidate the complex changes in the complement-leukocyte system during cardiopulmonary bypass (CPB), plasma levels of C3d, C5a, and granulocyte elastase bound to alpha1-proteinase inhibitor (E-alpha1 PI) were followed prior to, during, and after CPB. Leukocyte and differential cell counts and granulocyte migration were also determined. Complement activation was documented during CPB by an increase in plasma C3d corrected for hemodilution. Significant amounts of C5a were not revealed. Cell counts decreased during CPB but, if corrected for hemodilution, remained unchanged apart from a slight decrease in lymphocyte count after 60 minutes. Eighteen hours after CPB, neutrocytosis and lymphopenia occurred. Plasma E-alpha1 PI increased during CPB, reflecting release of granulocyte lysosomal enzymes. Granulocyte migration was transitorily depressed during CPB, and it was shown that this was due to the appearance of an intrinsic cellular defect. CPB is associated with acute changes in cells and plasma, resembling an acute whole-body inflammatory response, with transitory impairment of granulocyte migration. The clinical significance of these observations remains to be determined.
Knudsen
F
F
Department of Anesthesia and Intensive Care, Aalborg Hospital, Denmark.
Pedersen
J O
JO
Juhl
O
O
Nielsen
A H
AH
Jersild
C
C
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002634:Chemotaxis, Leukocyte / Q000276:immunology*; D003167:Complement Activation / Q000276:immunology; D015933:Complement C3d / Q000032:analysis* / Q000378:metabolism; D015936:Complement C5a / Q000032:analysis* / Q000378:metabolism; D005260:Female; D006098:Granulocytes / Q000502:physiology; D006400:Hematocrit / Q000706:statistics & numerical data; D006438:Hemodilution; D006801:Humans; D007432:Intraoperative Period / Q000706:statistics & numerical data; D007958:Leukocyte Count / Q000379:methods; D019272:Leukocyte Elastase / Q000097:blood*; D007962:Leukocytes / Q000276:immunology*; D007970:Leukopenia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors
D015933:Complement C3d; D015936:Complement C5a; D019272:Leukocyte Elastase