Amelioration of lung reperfusion injury by L- and E- selectin blockade.

Abstract

OBJECTIVE:

Reperfusion injury is the main reason for early graft failure after lung transplantation. Inhibition of the adherence of polymorphonuclear leukocytes to activated endothelium by blocking L- and E-selectins (antibody EL-246) could potentially inhibit reperfusion injury.

METHODS:

Reperfusion injury was induced in a left lung autotransplant model in sheep. After hilar stripping the left lung was flushed with Euro-Collins solution and preserved for 2 h in situ at 15 degrees C. After reperfusion right main bronchus and pulmonary artery were occluded leaving the animal dependent on the reperfused lung (control, n = 6). Pulmonary function was assessed by alveolo-arterial oxygen difference (AaDO2) and pulmonary vascular resistance (PVR), the chemiluminescence of isolated neutrophils, as well as the release of beta-N-acetyl-glucosaminidase (beta-NAG) served as indicator of neutrophilic activation. Extravascular lung water was an indicator for pulmonary edema formation. EL-246 group animals (n = 6) were treated additionally with 1 mg/kg BW of EL-246 given prior and during reperfusion.

RESULTS:

After 3 h of reperfusion five control animals developed alveolar edema compared to one animal in the EL-246 group (P = 0.08). AaDO2 (mm Hg) was significantly higher in the control compared to the EL-246 group (510 +/- 148 vs. 214 +/- 86). PVR (dyn x s x cm(-5)) was significantly increased in the control compared to the EL-246 group (656 +/- 240 vs. 317 +/- 87). Neutrophilic activation was significantly lower in the EL-246 group. Extravascular lung water was significantly lower compared to control (6.88 +/- 1.0 vs. 13.4 +/- 2.8 g/g blood-free lung weight).

CONCLUSIONS:

Treatment with EL-246 results in improved pulmonary function and less in vivo PMN activation in this experimental model. Further studies are necessary to evaluate the possible role of selectin blockade in amelioration of reperfusion injury in human lung transplantation.

• Authors: S Demertzis, F Langer, T Graeter, A Dwenger, T Georg, H J Schäfers
• Journal: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (Eur J Cardiothorac Surg) Vol. 16 Issue 2 Pg. 174-80 (Aug 1999) ISSN: 1010-7940 [Print] Germany
• PMID: 10485417 (Publication Type: Journal Article)

Chemical References

• Antibodies, Blocking
• Antibodies, Monoclonal
• E-Selectin
• L-Selectin
• Acetylglucosaminidase

Topics

• Acetylglucosaminidase (metabolism)
• Animals
• Antibodies, Blocking (pharmacology)
• Antibodies, Monoclonal
• Biopsy
• Body Water (metabolism)
• Disease Models, Animal
• E-Selectin (drug effects, immunology)
• Endothelium, Vascular (metabolism)
• Female
• Injections, Intravenous
• L-Selectin (drug effects, immunology)
• Lung (blood supply, metabolism, pathology)
• Lung Transplantation
• Neutrophil Activation (drug effects)
• Neutrophils (drug effects, enzymology)
• Pulmonary Edema (metabolism, physiopathology, prevention & control)
• Pulmonary Gas Exchange
• Reperfusion Injury (complications, physiopathology, prevention & control)
• Sheep
• Vascular Resistance