Evidence for neutrophil-related acute lung injury after intestinal ischemia-reperfusion. Surgery 1989 Aug;106(2):195-201; discussion 201-2
Date
08/01/1989Pubmed ID
2763027Scopus ID
2-s2.0-0024433830 (requires institutional sign-in at Scopus site) 213 CitationsAbstract
Intestinal ischemia-reperfusion injury is a common and important clinical event associated with the activation of an endogenous inflammatory response. Some of the mediators of this response may be involved in the pathogenesis of multiple organ system failure. The purpose of this study was to determine whether remote organ dysfunction--specifically, acute lung injury--occurs after intestinal ischemia-reperfusion injury. After an ischemia-reperfusion event in rat intestine, whole lungs were obtained for measurement of tissue adenosine triphosphate (ATP) and myeloperoxidase values, and evaluation of histologic condition. In addition, lung microvascular permeability was assessed by determination of the rate at which iodine 125-labeled bovine serum albumin sequestration in the extravascular compartment occurred. Lung tissue ATP levels were no different in sham-operated animals than in those that had undergone 120 minutes of intestinal ischemia. Within 15 minutes of gut reperfusion, however, lung ATP decreased from 3.82 +/- 0.27 to 1.53 +/- 0.90 x 10(-7) moles/50 mg tissue, p less than 0.05. Neutrophil accumulation in the lungs, estimated by tissue myeloperoxidase determination, increased sevenfold (0.13 +/- 0.02 to 0.97 +/- 0.25 units/gm, p less than 0.05) after 120 minutes of ischemia and 15 minutes of reperfusion. Lung microvascular permeability increased threefold after 120 minutes of intestinal ischemia and 120 minutes of reperfusion (0.10 +/- 0.01 vs. 0.35 +/- 0.05 [lung/blood counts per minute], p less than 0.05). Intestinal ischemia followed by reperfusion is associated with acute lung injury characterized by increased microvascular permeability, histologic evidence of alveolar capillary endothelial cell injury, reduced lung tissue ATP levels, and the pulmonary sequestration of neutrophils. These data confirm an acute lung injury associated with intestinal ischemia-reperfusion and suggest a possible pathogenic role for the neutrophil.
Author List
Schmeling DJ, Caty MG, Oldham KT, Guice KS, Hinshaw DBMESH terms used to index this publication - Major topics in bold
Acute DiseaseAdenosine Triphosphate
Animals
Capillary Permeability
Cell Movement
Endothelium, Vascular
Intestines
Ischemia
Lung
Lung Diseases
Microcirculation
Neutrophils
Pulmonary Alveoli
Pulmonary Circulation
Rats
Rats, Inbred Strains
Reperfusion Injury
