Neutrophil elastase activity in pulmonary venous blood during lung resection

Abstract

OBJECTIVES: Neutrophil elastase has been reported to play an important role in acute lung injury, which is a major cause of postoperative mortality after pulmonary resection. Neutrophil elastase released in the lungs reaches the peripheral circulation via the pulmonary veins. This study was performed to compare neutrophil elastase activity in pulmonary venous blood (collected during lobectomy) with that in the peripheral blood, and to determine the perioperative changes of neutrophil elastase activity. METHODS:In 34 patients undergoing lobectomy with mediastinal lymph node dissection, the leucocyte count, neutrophil count, neutrophil elastase activity and levels of tumour necrosis factor-α, interleukin-6 and interleukin-8 were measured in the pulmonary venous blood and peripheral arterial blood before and after surgery. Then, these parameters were compared between before and after surgery with peripheral and pulmonary blood.RESULTS: Neutrophil elastase activity was found to be significantly higher in pulmonary venous blood at the completion of surgery than at the start (during thoracotomy), while the neutrophil elastase activity of peripheral arterial blood showed no significant change between the start and completion of surgery. CONCLUSIONS:In conclusion, measurement of neutrophil elastase activity in pulmonary venous blood revealed changes associated with lobectomy.

Neutrophil extracellular traps in cancer progression

“…Elevated serum levels of NE have been demonstrated following both pulmonary and esophageal surgical procedures [99][100][101][102]. This elevation may be associated with adverse outcomes relating to pulmonary function following thoracic surgical procedures such as acute respiratory distress syndrome (ARDS) [99][100][101][102].…”

“…Elevated serum levels of NE have been demonstrated following both pulmonary and esophageal surgical procedures [99][100][101][102]. This elevation may be associated with adverse outcomes relating to pulmonary function following thoracic surgical procedures such as acute respiratory distress syndrome (ARDS) [99][100][101][102]. Accordingly, a number of studies have been performed examining both the safety of perioperative sivelestat and its efficacy in preventing postoperative adverse events [99][100][101][102].…”

“…This elevation may be associated with adverse outcomes relating to pulmonary function following thoracic surgical procedures such as acute respiratory distress syndrome (ARDS) [99][100][101][102]. Accordingly, a number of studies have been performed examining both the safety of perioperative sivelestat and its efficacy in preventing postoperative adverse events [99][100][101][102]. Kawahara et al [102] performed a randomized controlled trial (RCT) in which 22 patients were randomized to receive perioperative sivelestat (n = 11) or placebo (n = 11) for video-assisted thoracic surgery (VATS) for primary lung cancer.…”