title: Impairment of leukocyte deformability in patients undergoing esophagectomy.
abstract: Impaired deformability might contribute to the accumulation of activated leukocytes within pulmonary microcapillaries, leading to acute lung injury. The purpose of our study was to investigate changes in leukocyte deformability during periods of inflammation after esophagectomy. The study group comprised 20 patients who underwent esophagectomy. Changes in leukocyte deformability were investigated by examining filtration through a silicon microchannel, which simulated human pulmonary microcapillaries. Changes in the neutrophil cytoskeleton were investigated by measuring neutrophil F-actin assembly. The severity of patient clinical outcome was evaluated by the lung injury score. Leukocyte filtration through the microchannel was significantly weaker in esophagectomy patients than in healthy subjects (p<0.01). After esophagectomy, filtration was further impaired compared with preoperative values (p<0.05). The neutrophil F-actin content was higher in patients than in controls (p<0.01), and increased after esophagectomy compared with preoperative values (p<0.01). We concluded that circulating leukocytes showed reduced deformability and appeared to be sequestered within microcapillaries after esophagectomy. Changes in neutrophil cytoskeleton were considered to be responsible for the reduced deformability. Leukocyte accumulation within pulmonary microcapillaries might be related to the pathogenesis of lung injury after esophagectomy.
authors.affiliation: Department of Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Suemori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizobuchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
authors.forename: Yuki
authors.initials: Y
authors.lastname: Katanosaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mohri
authors.forename: Keiji
authors.initials: K
authors.lastname: Naruse
mesh_terms: D055371:Acute Lung Injury / Q000276:immunology* / Q000503:physiopathology; D016022:Case-Control Studies; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005434:Flow Cytometry; D018056:Hemorheology / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000276:immunology; D046210:Microfluidic Analytical Techniques; D009504:Neutrophils / Q000502:physiology* / Q000648:ultrastructure; D011183:Postoperative Complications / Q000276:immunology*; D011652:Pulmonary Circulation / Q000276:immunology