Activated polymorphonuclear leukocytes enhance production of leukocyte microparticles with increased adhesion molecules in patients with sepsis
Activated polymorphonuclear leukocytes enhance production of leukocyte microparticles with increased adhesion molecules in patients with sepsis
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DOI：
10.1097/00005373-200203000-00005
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发表时间：
2002-03-01
影响因子：
--
通讯作者：
Sugimoto, H
中科院分区：
文献类型：
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作者：
Fujimi, S;Ogura, H;Sugimoto, H
背景：最近在体外研究中发现，来源于多形核白细胞（PMNLs）的白细胞微粒（MPs）是血管内皮的激活剂。在遭受严重损伤的患者中，白细胞MPs的确切作用尚未明确。本研究的目的是评估脓毒症患者白细胞MPs的产生和MP表面粘附分子的表达。方法：选取21例重症感染患者（符合败血症标准，血清c反应蛋白> 10 mg/dL）和21例健康志愿者作为研究对象。通过流式细胞术检测存在和不存在甲酰基-甲硫基-亮基-苯丙氨酸的情况下，白细胞MPs的产生、MPs上CD11b的表达和PMNLs的氧化活性。根据MP的大小（大于、等于或小于1.0 mum）评估CD11b的表达。同时测定血中可溶性e -选择素、血栓调节素和PMNL弹性酶。与正常志愿者相比，脓毒症患者白细胞MPs和超氧化物的产生在含甲氧基-蛋氨酸-亮基-苯丙氨酸和不含甲氧基-苯丙氨酸的PMNLs中显著增加。在脓毒症患者中，与对照组相比，CD11b在直径小于1.0 μ m的MPs上的表达也明显增强。脓毒症患者血液中可溶性e选择素、血栓调节素和PMNL弹性酶水平显著升高。我们成功地用荧光显微镜目视检测了白细胞MPs。结论：活化PMNLs可促进脓毒症患者白细胞MPs的产生，并增加黏附分子。在脓毒症中，活化的白细胞MPs可能在内皮细胞活化和白细胞-内皮细胞相互作用的发病机制中发挥作用。
Background: Leukocyte microparticles (MPs) derived from polymorphonuclear leukocytes (PMNLs) have been recently found to be activators of vascular endothelium in vitro. The precise role of leukocyte MPs has not been clarified in patients suffering severe insult. The objective of this study was to evaluate production of leukocyte MPs and expression of adhesion molecules on the MP surface in patients with sepsis.Methods: Twenty-one patients with severe infection (fulfilling the criteria of sepsis with serum C-reactive protein > 10 mg/dL) and 21 healthy volunteers were included as study subjects. Production of leukocyte MPs, expression of CD11b on the MPs, and oxidative activity of PMNLs were measured by flow cytometry in the presence and absence of formyl-methionyl-leucyl-phenylalanine. CD11b expression was evaluated according to the MP size (more than, equal to, or less than 1.0 mum). Soluble E-selectin, thrombomodulin, and PMNL elastase were also measured in blood.ROWS. Production of leukocyte MPs and superoxide production in PMNLs with and without formyl-methionyl-leucyl-phenylalanine increased significantly in patients with sepsis in comparison with production in normal volunteers. In patients with sepsis, expression of CD11b was also markedly enhanced on MPs less than 1.0 mum in diameter in comparison with expression in control subjects. Levels of soluble E-selectin, thrombomodulin, and PMNL elastase in blood were significantly increased in patients with sepsis. We succeeded in detecting leukocyte MPs visually by fluorescence microscopy.Conclusion: Activated PMNLs enhance production of leukocyte MPs with increased adhesion molecules in patients with sepsis. Activated leukocyte MPs may play a role in the pathogenesis of endothelial activation and leukocyte-endothelium interaction in the presence of sepsis.