To cite this article: Pillay J, Kamp VM, Pennings M, Oudijk E-J, Leenen LP, Ulfman LH, Koenderman L. Acute-phase concentrations of soluble fibrinogen inhibit neutrophil adhesion under flow conditions in vitro through interactions with ICAM-1 and MAC-1 (CD11b/CD18). J Thromb Haemost 2013; 11: 1172-82.Summary. Background: Immobilized fibrinogen and fibrin facilitate leukocyte adhesion, as they are potent ligands for leukocyte MAC-1 (CD11b/CD18). However, fibrinogen in its soluble form also binds to MAC-1, albeit with low affinity. The level of soluble fibrinogen is increased during chronic and acute inflammation, but the function of this increase is unknown. Objectives: To study the effect of soluble fibrinogen in concentrations found in severe acute inflammation on leukocyte adhesion. Methods: Isolated leukocytes and soluble fibrinogen were studied in various in vitro settings under static and under flow conditions. Results: Soluble fibrinogen functioned as a natural antagonist of neutrophil functions that are dependent on MAC-1, such as the respiratory burst induced by unopsonized zymosan and adhesion to ICAM-1 and heparin. In addition, soluble fibrinogen inhibited lymphocyte functionassociated antigen 1-dependent lymphocyte binding to ICAM-1 through a direct interaction with ICAM-1. Soluble fibrinogen reduced MAC-1-dependent binding of interleukin-8-activated neutrophils to ICAM-1-expressing cells under flow conditions. Importantly soluble fibrinogen in acute-phase concentrations (4-10 mg mL À1 ) dosedependently reduced neutrophil firm adhesion to tumor necrosis factor-a-activated endothelium to 40% under flow conditions. Conclusions: We propose a model in which the increased circulating concentrations of soluble fibrinogen found during the acute-phase response can act as a natural antagonist of leukocyte recruitment, and therefore might contribute to the resolution of inflammation.