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Visualization of Neutrophil Extracellular Traps in Mesenteric Venules After Mesenteric Ischemia-Reperfusion Injury via Intravital Microscopy
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Visualization of Neutrophil Extracellular Traps in Mesenteric Venules After Mesenteric Ischemia-Reperfusion Injury via Intravital Microscopy

Published on: September 27, 2024

Enhanced polymorphonuclear neutrophil-mediated endothelial cell injury and its relation to high surgical mortality

Y Shimizu1, M Miyazaki, H Ito

  • 1First Department of Surgery, School of Medicine, Chiba University, Japan.

The American Journal of Gastroenterology
|November 24, 1999
PubMed
Abstract

Insights

Polymorphonuclear neutrophils (PMN) show increased injury potential in cirrhosis patients, contributing to higher postoperative complications after liver surgery. This PMN "priming" highlights a key factor in surgical outcomes for liver disease.

Area of Science:

  • Hepatology
  • Immunology
  • Vascular Biology

Background:

  • Patients with cirrhosis exhibit a high incidence of postoperative complications after surgery.
  • Polymorphonuclear neutrophils (PMN) can injure vascular endothelium and cause organ damage.
  • Altered PMN function is observed in cirrhosis, but their role in post-hepatectomy complications is under-investigated.

Purpose of the Study:

  • To evaluate the potential of PMN to cause endothelial cell injury in patients with cirrhosis.
  • To investigate the link between PMN-mediated endothelial damage and postoperative complications in cirrhosis.

Main Methods:

  • Hepatic resection was performed on patients with normal liver and metastatic liver carcinoma, and patients with cirrhosis and hepatocellular carcinoma.
  • PMN were isolated from patients pre-operation and co-cultured with human umbilical vein endothelial cells.
  • Lactate dehydrogenase (LDH), thrombomodulin release, and PMN elastase activity were measured.

Main Results:

  • Cirrhosis patients showed significantly higher release of LDH and thrombomodulin compared to normal liver patients.
  • PMN elastase activity was also significantly elevated in the cirrhosis group.
  • Surgical morbidity was 50% in cirrhosis patients versus 0% in normal liver patients.

Conclusions:

  • PMN possess an enhanced capacity for endothelial cell injury in patients with cirrhosis.
  • This PMN "priming" is a likely contributor to the increased postoperative complications observed after hepatectomy in cirrhosis patients.

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