Human Polymorphonuclear Cell Death after Exposure to Resuscitation Fluids In Vitro

Abstract

Hypertonic fluids and dextran decrease human polymorphonuclear cell survival through necrotic and apoptotic pathways, respectively.

Fluid Resuscitation

“…The results with dextran solutions have been similarly mixed in animal models, depending on its concentration and molecular size. Dextran-70 appears neutral or beneficial with regard to immunologic effects based on the findings of Schmand et al (63) and Stanton et al (64) that it neither suppressed nor restored macrophage IL-6 release and our finding that it reduced neutrophil burden through apoptotic mechanisms. However, we have also found dextran-40 to induce neutrophil oxidative burst and excitation more profoundly than even racemic LR (48).…”

“…In addition to research examining its hemodynamic properties, laboratory research into the immunomodulatory potential of HTS has been more promising than that of colloids and crystalloids. We have shown in the laboratory that HTS modulates neutrophil response by blocking neutrophil activation (animal model), halting E- and L-selectin neutrophil adhesion molecule expression (animal model), and inducing neutrophil death through necrosis ( in vitro human blood) (48, 54, 64). Using gene array technology on animal tissue, we also found that HTS does not induce expression of a number of IL receptor genes (IL-1, IL-6, and IL-8) as well as CD45, CD24 precursor, and STAT3 (45).…”

“…However, the effect of HTS-D on acidemia has been mixed in animal studies; some have found HTS-D more effective than other solutions at correcting acid-base disturbances (92), whereas others have not seen improvement in hemorrhage-induced acidosis (93). In the laboratory, HTS-D has been shown to blunt the hemorrhage-induced inflammatory response by decreasing neutrophil adhesion to hepatic sinusoidal endothelium (animal model) (94), by contributing to neutrophil attrition through the induction of necrosis ( in vitro model of human cells) (64), and by reducing CD11b expression and cytokine response to infectious sources ( in vitro model of human cells) (73). Finally, Rizoli et al (95) found these same immunomodulatory effects of HTS-D in humans in their placebo-controlled double-blind clinical trial (DBRCT) comparing a 250 mL bolus of HTS-D (n = 10) with a 250 mL bolus of NS (n = 14) in blunt trauma patients with obvious clinical signs of hemorrhage.…”

Hypertonic Saline Resuscitation After Mesenteric Ischemia/Reperfusion Induces Ileal Apoptosis

“…We and others have shown that the D-isomer of lactate in LR is proinflammatory. 4,5 Moreover, banked blood has been shown to contain proinflammatory cytokines and lipid mediators whose levels increase with the length of storage time. 6 Our Trauma Research Center (TRC) has been characterizing I/R-induced proinflammation after superior mesenteric artery occlusion (SMAO).…”

Le s�rum sal� hypertonique en 2004

“…Dans le cadre des SIRS ou dans les syndromes de détresse respiratoire aiguë de l'adulte (SDRA), on observe une activation des polynucléaires neutrophiles (PN). Le SSH augmente la nécrose des PN et diminuerait ainsi l'intensité de la réponse inflammatoire et l'accumulation de ces cellules notamment au niveau alvéolaire[35]. L'hypertonicité plasmatique pourrait aussi diminuer l'adhésion et la migration des leucocytes au-delà de la barrière endothéliale ainsi que l'expression membranaire des intégrines, sélectines et de molécules d'adhésion (ICAM)[36].…”