title: Sivelestat prevents cytoskeletal rearrangements in neutrophils resulting from lung re-expansion following one-lung ventilation during thoracic surgery.
abstract: Patients undergoing lobectomy are at risk of developing acute lung injury resulting from one-lung ventilation (OLV) during surgery. We investigated the morphological and functional behavior of neutrophils in patients who underwent lobectomy and assessed the ability of sivelestat to inhibit neutrophil activity. This was a blinded randomized study. Sixteen patients who underwent lobectomy were given intravenous sivelestat (n = 8) or intravenous saline (n = 8). We studied the cytoskeletal rearrangements of circulating neutrophils by determining the localization of filamentous actin (F-actin). Pulmonary oxygenation was evaluated by measuring the partial pressure of arterial oxygen. We found that the number of circulating, F-actin-rimmed neutrophils increased during OLV and after lung re-expansion. Our results suggest that, in addition to the surgical procedure and OLV, re-expansion of the remaining lung after lobectomy increases the neutrophil activation levels. Furthermore, administration of sivelestat limited neutrophil activation and improved pulmonary oxygenation in our patients.
authors.affiliation: Department of Thoracic Surgery, Shinshu University School of Medicine, Matsumoto, Japan, tks1976@shinshu-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Eguchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yoshida
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kondo
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Hamanaka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shiina
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Keishi
authors.initials: K
authors.lastname: Kubo
authors.forename: Jo
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Koizumi
mesh_terms: D008841:Actin Cytoskeleton / Q000187:drug effects / Q000378:metabolism; D000199:Actins / Q000187:drug effects / Q000378:metabolism; D055371:Acute Lung Injury / Q000188:drug therapy* / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D016209:Interleukin-8 / Q000097:blood; D008168:Lung / Q000601:surgery; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects* / Q000378:metabolism; D061810:One-Lung Ventilation; D010100:Oxygen / Q000097:blood*; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D019616:Thoracic Surgical Procedures
chemical_list: D000199:Actins; C508606:CXCL8 protein, human; D016209:Interleukin-8; D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; D008315:Malondialdehyde; C069195:sivelestat; D010100:Oxygen; D005998:Glycine