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Early role of neutrophil L-selectin in posttraumatic acute lung injury
T H Rainer1, N Y Lam, T Y Chan
1Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, Shatin, Hong Kong, China.
Objective:
To investigate whether early numerical and functional changes in circulating neutrophils and expression of neutrophil L-selectin and soluble L-selectin are related to the subsequent development of posttraumatic acute lung injury (ALI), the systemic inflammatory response syndrome, sepsis, and organ failure.
Design:
Prospective study of whole blood and plasma samples to assess numerical and functional changes in circulating neutrophils and in soluble L-selectin.
Setting:
The emergency department of a university hospital.
Patients:
A total of 147 patients admitted to the resuscitation room after trauma were compared with 69 control subjects. Ten patients developed ALI.
Laboratory Analysis:
Flow cytometry of whole blood and ELISA of plasma.
Results:
Total leukocyte and neutrophil counts, expression of L-selectin, and the ratio of neutrophil to plasma L-selectin increased with injury and were highest in those who developed ALI. Soluble L-selectin decreased with injury severity and was lowest in those who developed ALI.
Conclusions:
Early changes in the average expression of L-selectin per cell do not correlate with the development of subsequent posttraumatic ALI. However, the development of ALI is related to the total expression of L-selectin in the neutrophil mass, and the most striking association is in those with lower concentrations of plasma L-selectin.