Increased neutrophil migratory activity after major trauma: a factor in the etiology of acute respiratory distress syndrome?

摘要: OBJECTIVE Neutrophil infiltration of the lung is characteristic early posttraumatic acute respiratory distress syndrome (ARDS). This study examines ability neutrophils isolated (over first 24 hrs) from peripheral blood patients admitted after major trauma to migrate in response interleukin-8. Interleukin-8 elevated within 2 hrs who later develop ARDS, and thus it plays a central role recruitment their subsequent activation. We hypothesized that enhanced interleukin-8-mediated neutrophil migratory activity postinjury phase, before development may be crucial factor etiology ARDS. DESIGN Prospective observational study. SETTING University Hospital Wales, Royal Gwent Hospital, East Glamorgan General Hospital. Laboratory work was conducted at Institute Nephrology. PATIENTS Adult blunt victims with Injury Severity Score > or = 18. MEASUREMENTS AND MAIN RESULTS Neutrophils were citrated 17 adult admission (0 8 later. Identical samples obtained normal laboratory volunteers (n 9). The count each specimen measured, number migrating across porous tissue culture inserts defined concentrations interleukin-8 (0, 10, 30, 100 ng/mL) quantitated by peroxidase assay. counts whole specimens those developing ARDS significantly declined rapidly throughout next hrs. Significantly greater numbers patients' migrated (30 time point when compared (Mann-Whitney U test, p <.05). exhibited an high admission, contrast physiologic attenuation migration seen volunteers. CONCLUSIONS These data indicate enhances capacity circulating neutrophils. manifest attributable alteration receptor expression, affinity, downstream signaling. In initially decrease rapidly, over same course. Early coupled pulmonary establishment