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Mechanical trauma in leukocytes

T S Dewitz, T C Hung, R R Martin

    The Journal of Laboratory and Clinical Medicine
    |October 1, 1977
    PubMed
    Summary
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    Shear stress in cardiopulmonary bypass circuits damages human leukocytes, reducing cell counts and altering morphology and function. This damage occurs at lower stress levels than previously thought.

    Area of Science:

    • Biomedical Engineering
    • Hematology
    • Cell Biology

    Background:

    • Cardiopulmonary bypass (CPB) circuits involve mechanical and surface trauma.
    • This trauma is known to affect human leukocyte function and morphology.
    • Understanding these effects is crucial for improving CPB procedures.

    Purpose of the Study:

    • To investigate the impact of controlled in vitro shear stress on human leukocytes.
    • To assess changes in cell count, morphology, adhesiveness, and enzyme activity.
    • To determine the shear stress thresholds for these alterations.

    Main Methods:

    • Whole blood from healthy donors was exposed to controlled shear stress (0–2,000 dynes/cm², 2–10 min, 37°C).
    • Evaluated parameters included electronic cell counts, blood smear morphology, leukocyte adhesiveness (nylon fiber columns), and alkaline/acid phosphatase cytochemical staining.

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  • Specific shear stress levels were applied to identify thresholds for observed effects.

    • Main Results:

    • Electronic cell counts significantly decreased with shear stress exposure (e.g., 25% reduction at 600 dynes/cm² for 10 min).
    • Leukocyte disruption and aggregation increased with shear stress above 150 dynes/cm².
    • Alkaline phosphatase activity in neutrophils significantly decreased at ≥150 dynes/cm² (10 min), while acid phosphatase remained largely unaffected.
    • Increased retention in nylon fibers indicated elevated leukocyte adhesiveness post-shear stress.

    Conclusions:

    • In vitro shear stress significantly alters human leukocyte morphology and function.
    • Leukocyte damage and functional changes occur at shear stress levels lower than those causing erythrocyte hemolysis.
    • Findings suggest CPB-induced shear stress may compromise leukocyte integrity and function during cardiac surgery.