INDUCTION OF INTERCELLULAR-ADHESION MOLECULE-1 AND E-SELECTIN MESSENGER-RNA IN HEART AND SKELETAL-MUSCLE OF PEDIATRIC-PATIENTS UNDERGOING CARDIOPULMONARY BYPASS

Leukocyte adhesion to vascular endothelium is an early step in inflamm atory damage to tissues. To investigate the expression of endothelial adhesion molecules in the inflammatory response associated with cardio pulmonary bypass, we measured messenger ribonucleic acid (mRNA) encodi ng the adhesion molecules E-selectin and intercellular adhesion molecu le-1 in intraoperative samples of cardiac tissue and skeletal muscle f rom infants undergoing cardiopulmonary bypass. Atrial tissue samples w ere obtained before and after bypass from II children and paired sampl es of rectus abdominis muscle from 15. mRNA was analyzed by ribonuclea se protection with the use of nonmuscle actin as an internal control. Atrial E-selectin mRNA levels increased from before to after bypass (m edian increase 3.5-fold, p = 0.0002) in each of nine patients tested, and atrial intercellular adhesion molecule-1 mRNA increased in seven o f nine patients (median, 2.1-fold, p = 0.025). In skeletal muscle, E-s electin mRNA increased in 11 of 12 patients (median 4.3-fold, p = 0.00 18), and intercellular adhesion molecule-1 mRNA levels increased in 13 of 13 patients (median 3.2-fold, p = 0.013). E-selectin and intercell ular adhesion molecule-1 induction in skeletal muscle occurred with or without circulatory arrest. We conclude that adhesion molecule mRNA i nduction occurs in cardiac and noncardiac tissue during cardiopulmonar y bypass in man.