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Interaction between neutrophils and endothelium
1Hospital for Sick Children, London, England.
Insights
Cardiopulmonary bypass in children triggers an inflammatory response, increasing neutrophil adhesion to the endothelium. This capillary leak is linked to changes in adhesion molecules and interleukin-8, requiring further research for clinical applications.
Area of Science:
- Pediatric cardiovascular surgery
- Inflammatory response
- Endothelial permeability
Background:
- Cardiopulmonary bypass (CPB) in children can induce endothelial dysfunction.
- Neutrophil-endothelial interactions are key to capillary leak during CPB.
- Understanding these interactions is crucial for managing CPB-related complications.
Purpose of the Study:
- To review mechanisms of neutrophil-endothelial adhesion during pediatric CPB.
- To examine evidence for modulation of these adhesion processes.
- To investigate the role of specific adhesion molecules and cytokines.
Main Methods:
- Review of current literature on neutrophil-endothelial adhesion.
- Analysis of changes in L-selectin and CD11b/CD18 expression during pediatric CPB.
- In vitro studies on the effects of CPB-associated factors on adhesion molecules and interleukin-8.
Main Results:
- CPB in children is associated with decreased L-selectin and increased CD11b/CD18 expression.
- Interleukin-8 may play a role in modulating neutrophil-endothelial adhesion.
- CPB procedures (temperature, circulation changes) up-regulate adhesion molecules and interleukin-8 release in vitro.
Conclusions:
- Pediatric CPB induces significant changes in neutrophil adhesion molecule expression.
- Cytokines like interleukin-8 and procedural factors influence these adhesion mechanisms.
- Further research is needed to define precise mechanisms and clinical correlations.
Abstract:
The endothelial permeability associated with cardiopulmonary bypass in children is due, at least in part, to an inflammatory response. Neutrophils and their relationship with endothelium are fundamental to the production of capillary leak. This review discusses current concepts of the mechanisms involved in adhesion between neutrophils and the endothelium and its control. Evidence for modulation of these changes during bypass in children is reviewed. We have shown that cardiopulmonary bypass in children is associated with down-regulation (or shedding) of L-selectin and up-regulation of expression of CD11b/CD18. There may be a role for the cytokine interleukin-8 in the modulation of this process. We have demonstrated in vitro that certain of the procedures associated with bypass are associated with up-regulation of circulating neutrophil adhesion molecules and with the release of interleukin-8. These factors include changes in temperature and circulation. More research is required to tease out the most important components of the mechanisms of adhesion, and clinical correlations must be defined.