Expression of beta 2-integrins and L-selectin on polymorphonuclear leukocytes in septic patients.
Expression of beta 2-integrins and L-selectin on polymorphonuclear leukocytes in septic patients.
复制标题
脓毒症患者多形核白细胞上β2-整合素和L-选择素的表达。
DOI：
10.1159/000129521
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Peter,K
中科院分区：
文献类型：
--
作者：
Thiel,M;Zourelidis,C;Chambers,JD;vonAndrian,UH;Arfors,KE;Messmer,K;Peter,K
多形核白细胞(PMNL)上的黏附分子在针对入侵微生物的非特异性防御机制中起重要作用。然而，当局部感染无法控制时，全身炎症反应综合征(SIRS)随之而来，可能进展为感染性休克和多器官衰竭，这些都是患者预后的主要决定因素。本研究检测了17例脓毒症患者和15例健康志愿者外周血中β-2-整合素和L-选择素的表达。用抗CD18的β单抗和抗CD62L的Dreg200单抗，用流式细胞仪检测CD2整合素和CD62L-选择素分子。在采集血液后立即测定黏附分子，并在体外细胞在体温下孵育45min后测定黏附分子，以允许自发调节。此外，PMNL被受体依赖和受体非依赖刺激激活，以表征刺激特异性黏附分子的表达。在测量黏附分子的同时，通过Elebute评分评估脓毒症的严重程度。结果显示，健康志愿者、存活者(n=11)和死亡者(n=6)的基础、自发和刺激诱导的黏附分子表达有显著差异。此外，当比较存活和死亡的严重脓毒症患者(Elebute Score>；12)时，死亡患者的β2-整合素和L-选择素的基础表达均显著降低。因此，循环PMNL上黏附分子的测定可能有助于识别具有致死性结局的高危败血症患者。
Adhesion molecules on polymorphonuclear leukocytes (PMNL) play an important role in nonspecific defense mechanisms directed at invading microorganisms. When local infection, however, cannot be controlled, a systemic inflammatory response syndrome (SIRS) ensues which may progress to septic shock and multiple organ failure, these being major determinants of the patient’s outcome. In the present study, the expression of β2-integrins and L-selectin on blood PMNL was measured on subsequent days in patients with sepsis (n = 17) and in healthy volunteers (n = 15). β2-Integrins and L-selectin molecules were detected by flow cytometry, using the monoclonal antibodies IB4 (anti-CD 18) and Dreg200 (anti-CD62L), respectively. Adhesion molecules were determined at baseline immediately after blood collection and also 45 min after incubation of cells in vitro at body temperature to allow for spontaneous regulation. In addition, PMNL were activated by receptor-dependent and receptor-independent stimuli to characterize stimulus-specific adhesion molecule expression. In parallel with the measurement of adhesion molecules, severity of sepsis was assessed by the Elebute score. The results demonstrate significant differences in the basal, spontaneous and stimulus-induced expression of adhesion molecules between healthy volunteers, survivors (n = 11) and nonsurvivors (n = 6). Moreover, when survivors and nonsurvivors with severe sepsis (Elebute score > 12) were compared, basal expressions of both β2-integrins and L-selectin were significantly lower in patients who did not survive. Thus, measurement of adhesion molecules on circulating PMNL may be useful to identify septic patients at high risk for lethal outcome.