S. Cholletmartin et al., INTERACTIONS BETWEEN NEUTROPHILS AND CYTOKINES IN BLOOD AND ALVEOLAR SPACES DURING ARDS, American journal of respiratory and critical care medicine, 154(3), 1996, pp. 594-601
Citations number
35
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
Although the pathogenesis of the acute respiratory distress syndrome (
ARDS) is complex and poorly understood, several observations point to
an important role of interactions between polymorphonuclear neutrophil
s (PMN) and cytokines in this process. We therefore studied certain pa
rameters involved in PMN transendothelial migration (adhesion molecule
expression and cytoskeletal organization) in patients with ARDS (n =
14) in comparison with other ventilated patients (n = 15). We found th
at in the basal state, both whole-blood PMN and alveolar PMN obtained
by bronchoalveolar lavage (BAL) were activated, as shown by decreased
L-selectin CD62L and increased beta 2 integrin CD11b expression, as we
ll as decreased F-actin content. The degree of PMN activation increase
d with the degree of lung injury and with the levels of tumor necrosis
factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-8 (IL
-8). Moreover, the capacity of ex vivo stimulation of alveolar PMN by
a bacterial peptide was low in ARDS and could partly account for the h
igh susceptibility of these patients to lung infection. Therefore, ARD
S-associated lung injury could be caused, at least in part, by inappro
priate adhesion and transendothelial migration of proinflammatory cyto
kine-primed PMN.