The use of cylexin (CY-1503) in prevention of reperfusion lung injury in patients undergoing pulmonary thromboendarterectomy

Pulmonary thromboendartectomy (PTE) for chronic thromboembolic pulmonary hy pertension may be complicated by reperfusion lung injury. This has previous ly been demonstrated to be neutrophil-mediated. We postulated that blocking selectin-mediated adhesion of neutrophils to the endothelium with Cylexin (CY-1503) would prevent reperfusion lung injury in this patient population. In this double-blind, randomized, placebo-controlled, parallel study, 26 p atients received Cylexin the day of surgery and 25 received placebo. Signif icantly fewer patients in the treated group (31%) compared with the placebo group (60%) developed lung injury (p = 0.036). However, the average number of days of mechanical ventilation, days in the intensive care unit (ICU) a nd hospital, as well as mortality were not significantly different between the treatment groups. Those with reperfusion lung injury had significantly elevated percent neutrophils, total protein, and soluble D-selectin in bron choalveolar lavage fluid compared with those without lung injury. We conclu de that reperfusion lung injury after PTE is a high-permeability lung injur y and its incidence can he reduced by the administration of Cylexin on the day of surgery.