INCREASED NEUTROPHIL MOBILIZATION AND DECREASED CHEMOTAXIS DURING CORTISOL AND EPINEPHRINE INFUSIONS
INCREASED NEUTROPHIL MOBILIZATION AND DECREASED CHEMOTAXIS DURING CORTISOL AND EPINEPHRINE INFUSIONS
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DOI：
10.1097/00005373-199106000-00001
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发表时间：
1991-06-01
影响因子：
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通讯作者：
YURT, RW
中科院分区：
文献类型：
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作者：
DAVIS, JM;ALBERT, JD;YURT, RW
虽然激素是损伤后中性粒细胞变化的假定介质，但创伤诱导的血浆皮质醇和肾上腺素水平对循环中性粒细胞的影响尚未在人类中报道。 在19次肾上腺素或皮质醇输注或两种激素联合输注期间，对10名正常志愿者的PMN动员和趋化动力学进行了评价。 在输注过程中，肾上腺素和皮质醇的基础水平升高至与严重损伤后报告的水平一致。 循环中性粒细胞计数与血浆皮质醇水平平行增加。 肾上腺素动员了整个中性粒细胞边缘池，皮质醇使中性粒细胞半衰期从正常的6.6小时延长至10.4小时。 与基线趋化性相比，肾上腺素输注6小时后的趋化性降低。 在四名接受第二次皮质醇输注的志愿者中，与基线相比，输注后10天的趋化性显著降低。 从这些数据中，我们得出结论，肾上腺素的压力水平动员边缘池的粒细胞进入循环池中的线性方式，和皮质醇提高循环中性粒细胞的半衰期。 中性粒细胞趋化性降低被认为是这些输注的结果，这可能是严重创伤后感染易感性增加的原因。
Although hormones are putative mediators of neutrophil changes after injury, the effects of trauma-induced levels of plasma cortisol and epinephrine on circulating neutrophils have not been reported in humans. The dynamics of PMN mobilization and chemotaxis were evaluated during 19 infusions of epinephrine or cortisol or a combined infusion of both hormones in ten normal volunteers. Basal levels of epinephrine and cortisol increased during infusions to levels consistent with those reported following severe injury. Circulating neutrophil counts increased in parallel with plasma cortisol levels. Epinephrine mobilized the entire marginated pool of neutrophils, and the neutrophil half-life was extended from a normal of 6.6 hours to 10.4 hours by cortisol. Chemotaxis after six hours of epinephrine infusion was reduced compared with baseline chemotaxis. In four volunteers who had a second infusion of cortisol, chemotaxis was significantly depressed ten days after the infusion compared with baseline. From these data we conclude that stress levels of epinephrine mobilize the marginated pool of granulocytes into the circulating pool in a linear fashion, and cortisol raises the half-life of circulating neutrophils. Reduced neutrophil chemotaxis seen as a consequence of these infusions could account for some of the increased susceptibility to infection that occurs after major trauma.