K. Kawahito et al., Enhanced responsiveness of circulatory neutrophils after cardiopulmonary bypass: Increased aggregability and superoxide producing capacity, ARTIF ORGAN, 24(1), 2000, pp. 37-42
Cardiac surgery with cardiopulmonary bypass (CPB) induces a whole body infl
ammatory response that sometimes leads to postoperative organ dysfunction,
and neutrophil activation plays an important role in this reaction. Neutrop
hil priming has been described as a change in neutrophil status such that n
eutrophils show enhanced responsiveness to a second activating stimulus. We
hypothesized that neutrophil priming occurs by cardiac surgery with CPB an
d is temporally related to the neutrophilia after surgery. To evaluate prim
ed circulatory neutrophil status, we measured aggregation activity stimulat
ed by N-formyl-methyl-leucyl-phenyl-alanine (FMLP) and free radical produci
ng activity by tumor necrosing factor (TNF) a in peripheral blood samples.
Eleven adult patients undergoing elective cardiac surgery with CPB were stu
died. Blood samples were taken before surgery, at the end of bypass, 12 h a
fter surgery, and 7 days after surgery. Aggregation activity and superoxide
generation were significantly elevated 12 h after surgery when compared to
presurgery values, indicating that cardiac surgery is associated with circ
ulatory neutrophil priming. The number of neutrophils markedly increased at
the end of cardiopulmonary bypass and reached a peak 12 h after surgery. T
he circulatory neutrophils of cardiac surgical patients become primed after
surgery, coincident with the peak neutrophil count. These results suggest
that circulatory neutrophils after cardiac surgery with CPB have enhanced r
esponsiveness and are predisposed to systemic inflammation.