NEUTROPHIL-ACTIVATING PEPTIDE-2 IN PATIENTS WITH PULMONARY-EDEMA FROMCONGESTIVE-HEART-FAILURE OR ARDS

We carried out studies to determine whether the neutrophil-activation peptide-2 (NAP-2) plays a role in the recruitment and/or degranulation of neutrophils into the lungs of patients with the adult respiratory distress syndrome (ARDS) or congestive heart failure (CHF). NAP-2 prec ursors plus NAP-2 (beta-thromboglobulin-like antigen) were measured in lung fluids and plasmas with a radioimmunoassay, and NAP-2 was separa ted from its precursors by high-performance liquid chromatography. Pul monary edema fluids (PEFs) from patients with CHF contained higher con centrations of the beta-thromboglobulin-like antigen than PEFs from pa tients with ARDS, and bronchoalveolar lavage fluids (BALs) from patien ts with ARDS contained higher concentrations of beta-thromboglobulin-l ike antigen than BALs from normal subjects. Beta-thromboglobulin-like antigen concentration was 4.1-fold greater in PEFs from patients with CHF than in their plasmas. Chemotactically active NAP-2 was also demon strated in PEFs but not in plasmas from patients with CHF and ARDS. Th ese data suggest that significant platelet degranulation occurred into the lungs of the patients with CHF and that NAP-2 and other platelet constituents may contribute to fluid formation in patients with CHF.