Catecholamine-Induced Leukocytosis: Early Observations, Current Research, and Future Directions

Benschop, Robert J.; Rodriguez-Feuerhahn, Mario; Schedlowski, Manfred

doi:10.1006/brbi.1996.0009

Cited by 456 publications

(334 citation statements)

References 72 publications

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“…Large, prospective studies conducted in healthy populations have also shown an association between a raised WBC count and mortality [28,29]. The relationship between elevated WBC count and adverse outcomes remains incompletely understood because of its association with a multitude of underlying disease states, suggesting that elevated WBC may be an unspecific reaction to a variety of conditions, perhaps as part of a generalized stress response [30]. Thus, it is possible that WBCs have no causal role in death following PE but rather reflect an inflammatory response either to thrombosis or to its risk factors.…”

Section: Discussionmentioning

confidence: 99%

White blood cell count and mortality in patients with acute pulmonary embolism

et al. 2013

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Although associated with adverse outcomes in other cardiovascular diseases, the prognostic value of an elevated white blood cell (WBC) count, a marker of inflammation and hypercoagulability, is uncertain in patients with pulmonary embolism (PE). We therefore sought to assess the prognostic impact of the WBC in a large, state‐wide retrospective cohort of patients with PE. We evaluated 14,228 patient discharges with a primary diagnosis of PE from 186 hospitals in Pennsylvania. We used random‐intercept logistic regression to assess the independent association between WBC count levels at the time of presentation and mortality and hospital readmission within 30 days, adjusting for patient and hospital characteristics. Patients with an admission WBC count <5.0, 5.0–7.8, 7.9–9.8, 9.9–12.6, and >12.6 × 109/L had a cumulative 30‐day mortality of 10.9%, 6.2%, 5.4%, 8.3%, and 16.3% (P < 0.001), and a readmission rate of 17.6%, 11.9%, 10.9%, 11.5%, and 15.0%, respectively (P < 0.001). Compared with patients with a WBC count 7.9–9.8 × 109/L, adjusted odds of 30‐day mortality were significantly greater for patients with a WBC count <5.0 × 109/L (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.14–2.03), 9.9–12.6 × 109/L (OR 1.55, 95% CI 1.26–1.91), or >12.6 × 109/L (OR 2.22, 95% CI 1.83–2.69), respectively. The adjusted odds of readmission were also significantly increased for patients with a WBC count <5.0 × 109/L (OR 1.34, 95% CI 1.07–1.68) or >12.6 × 109/L (OR 1.29, 95% CI 1.10–1.51). In patients presenting with PE, WBC count is an independent predictor of short‐term mortality and hospital readmission. Am. J. Hematol. 88:677–681, 2013. © 2013 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

White blood cell count and mortality in patients with acute pulmonary embolism

et al. 2013

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“…However, ␤ 2 -AR are not hypothesized to play a critical role in the observed vascular inflammation because ICI-118551, a selective ␤ 2 -AR blocker, did not reverse it. Although ␤ 1 -AR appear to play a critical role in Epi-induced pulmonary vascular inflammation, the representation of ␤ 1 -AR on leukocytes is controversial (1).…”

Section: Discussionmentioning

confidence: 99%

“…The acute administration of catecholamines in murine species yields a transient increase in circulating lymphocytes with small increases in CD3 ϩ and CD8 ϩ lymphocytes and large increases in NK cells (1,24). But repeated challenges with the ␤ 2 -AR agonist terbutaline yields decreased numbers of circulating NK lymphocytes without significant changes in CD3 ϩ lymphocytes (18).…”

Section: Discussionmentioning

confidence: 99%

“…Epi induces the release of lymphocytes from the murine spleen and promotes their translocation into blood and lung (14). Epi rapidly increases circulating natural killer (NK) cells (24), modulates T-helper (Th) 1 activities (7), mobilizes granulocytes from marginal pools (1), and increases L-selectin expression (20) and LPS-mediated upregulation of TNF-␣ receptors by blood monocytes (11). In rats, Epi administered daily before antigen sensitization and through subsequent antigen challenge inhibits cutaneous tuberculin reactions (12).…”

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confidence: 99%

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Epinephrine promotes pulmonary angiitis: evidence for a β₁-adrenoreceptor-mediated mechanism

Jain

Zhao

Selig

et al. 2003

American Journal of Physiology-Lung Cellular and Molecular Phys

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. Epinephrine promotes pulmonary angiitis: evidence for a ␤1-adrenoreceptor-mediated mechanism. Am J Physiol Lung Cell Mol Physiol 285: L232-L239, 2003; 10.1152/ajplung.00248.2002 increases lymphocyte traffic to lung. We investigated whether Epi also modulates pulmonary cell-mediated immune responses in vivo. C57BL/6 mice were immunized with hen-egg lysozyme (HEL) on day 0, challenged with HEL intratracheally at day 12, and killed at day 15. Mice received Epi (0.5 mg/kg) subcutaneously during the sensitization phase, days 1-7 (Epi-SP), or the effector phase, days 12-14 (Epi-EP); controls received saline subcutaneously. Epi-SP mice showed increased airway inflammation (P Ͻ 0.03) and pulmonary angiitis (P Ͻ 0.04) characterized by endothelialitis and subendothelial fibrin deposition. Macrophages and granulocytes were increased in perivascular cuffs in situ (P Ͻ 0.001). CD3 ϩ lymphocytes increased in the bronchoalveolar lavage fluid, whereas NK1.1 ϩ and CD4 ϩ CD25 ϩ lymphocytes decreased (all P Ͻ 0.05). Atenolol, a selective ␤1-adrenoreceptor (AR) antagonist, inhibited the increased vascular and airway inflammation and the reduction in CD4 ϩ CD25 ϩ lymphocytes (all P Ͻ 0.05) yielded by Epi, whereas all ␣/␤-AR blockers inhibited airway inflammation. We conclude that Epi-EP selectively promotes vascular inflammation in vivo via a ␤ 1-receptor-mediated mechanism.

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“…These observations suggest that intrapartum stress could modulate the fetal immune response. Psychological 49 and physiological stressors are known to result in a significant redistribution of the lymphocyte population and increase the percentage of NK cells 50,51 in adult peripheral blood, probably through activation of the sympathetic nervous system 52,53 and/or the hypothalamic-pituitaryadrenal axis 54 . This phenomenon is mediated, in part, by 55 , including NK cells 56 .…”

Section: Journal Of Maternal-fetal and Neonatal Medicinementioning

confidence: 99%

Neonates born to pre-eclamptic mothers have a higher percentage of natural killer cells (CD3 - /CD56+16+) in umbilical cord blood than those without pre-eclampsia

White

Ahlstrand²

2003

DJMF

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Objective: Maternal endothelial dysfunction and intravascular inflammation have been implicated in the mechanisms of disease responsible for the clinical syndrome of pre-eclampsia. Recently, the activation of the innate limb of the immune response (neutrophils and monocytes) in the fetal circulation has been reported in neonates born to mothers with pre-eclampsia. Natural killer (NK) cells are identified morphologically as a subpopulation of lymphocytes, but functionally as one component of the innate immune system. NK cells participate in the control of viral or bacterial infection, regulation of hematopoiesis, production of cytokines and cytotoxicity of neoplastic cells. Accumulating evidence suggests that the innate system is required for mounting an adequate adaptive response. NK cells, originally defined as effector cells of the innate immune system, may also play a role as regulatory cells for the adaptive immune system. This study was designed to determine the proportion of the NK cell subset of lymphocytes in umbilical cord blood of neonates born to mothers with and without pre-eclampsia. Methods: A cross-sectional study including neonates of mothers with (n = 48) and those without pre-eclampsia (control group) (n = 72) was conducted. Pre-eclampsia was diagnosed in the presence of hypertension and proteinuria. The control group consisted of neonates (premature and term) with no evidence of acute inflammation within the extraplacental membranes (chorioamnionitis). Umbilical cord blood was collected at the time of delivery, and assayed using monoclonal antibodies for selective cluster differentiation (CD) antigens in order to determine the proportion of NK cells as a percentage of total lymphocytes. The immunophenotypic characteristic was determined using flow cytometry, and NK cells were identified by positivity of CD16 and CD56 without CD3 (CD3-/CD56+16+). Log transformation of the percentage of NK cells was performed. Parametric statistics were used for analysis. Multiple regression analysis was utilized to examine the contribution of potentially confounding factors on the proportion of NK cells. A p value of < 0.05 was considered statistically significant. Results: Neonates born to mothers with pre-eclampsia had a significantly higher percentage of NK cells (CD3-/CD56+16+) than those in the control group (pre-eclampsia, mean ± SD 17 ± 9% vs. control, mean ± SD 12 ± 7.5%; p = 0.001). Multiple regression analysis suggested that umbilical cord blood pH of < 7.2, labor with vaginal delivery and maternal pre-eclampsia were associated with an increased percentage of NK cells in umbilical cord blood. Conclusions: Pre-eclampsia is associated with a higher NK cell (CD3-/CD56+16+) subset of lymphocytes in umbilical cord blood than in the control group. This difference cannot be explained by fetal acidosis or the presence of labor.

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Catecholamine-Induced Leukocytosis: Early Observations, Current Research, and Future Directions

Cited by 456 publications

References 72 publications

White blood cell count and mortality in patients with acute pulmonary embolism

White blood cell count and mortality in patients with acute pulmonary embolism

Epinephrine promotes pulmonary angiitis: evidence for a β₁-adrenoreceptor-mediated mechanism

Neonates born to pre-eclamptic mothers have a higher percentage of natural killer cells (CD3 - /CD56+16+) in umbilical cord blood than those without pre-eclampsia

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Catecholamine-Induced Leukocytosis: Early Observations, Current Research, and Future Directions

Cited by 456 publications

References 72 publications

White blood cell count and mortality in patients with acute pulmonary embolism

White blood cell count and mortality in patients with acute pulmonary embolism

Epinephrine promotes pulmonary angiitis: evidence for a β1-adrenoreceptor-mediated mechanism

Neonates born to pre-eclamptic mothers have a higher percentage of natural killer cells (CD3 - /CD56+16+) in umbilical cord blood than those without pre-eclampsia

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Epinephrine promotes pulmonary angiitis: evidence for a β₁-adrenoreceptor-mediated mechanism