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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Intensive+Care
2018 ; 6
(ä): 19
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Leukadherin-1 ameliorates endothelial barrier damage mediated by neutrophils from
critically ill patients
#MMPMID29568527
Dickinson CM
; LeBlanc BW
; Edhi MM
; Heffernan DS
; Faridi MH
; Gupta V
; Cioffi WG
; O'Brien X
; Reichner JS
J Intensive Care
2018[]; 6
(ä): 19
PMID29568527
show ga
BACKGROUND: Multi-organ failure occurs during critical illness and is mediated in
part by destructive neutrophil-to-endothelial interactions. The ?2 integrin
receptor, CR3 (complement receptor 3; Mac-1; CD11b/CD18), which binds endothelial
intercellular adhesion molecule-1 (ICAM-1), plays a key role in promoting the
adhesion of activated neutrophils to inflamed endothelia which, when prolonged
and excessive, can cause vascular damage. Leukadherin-1 (LA-1) is a small
molecule allosteric activator of CR3 and has been shown to promote adhesion of
blood neutrophils to inflamed endothelium and restrict tissue infiltration.
Therefore, LA-1 offers a novel mechanism of anti-inflammatory action by
activation, rather than inhibition, of the neutrophil CR3 integrin. However,
whether promotion of neutrophil-to-endothelial interaction by this novel
therapeutic is of benefit or detriment to endothelial barrier function is not
known. METHODS: Critically ill septic and trauma patients were prospectively
enrolled from the surgical and the trauma ICU. Blood was collected from these
patients and healthy volunteers. Neutrophils were isolated by dextran
sedimentation and adhered to TNF-? (tumor necrosis factor-?)-activated human
umbilical vein endothelial (HUVEC) monolayers in the presence or absence of fMLP
(formylmethionine-leucine-phenylalanine) and/or LA-1. Electric cell-substrate
impedance sensing (ECIS) and exposure of underlying collagen were used to
quantify endothelial barrier function and permeability. RESULTS: Neutrophils from
critically ill trauma and septic patients caused similar degrees of endothelial
barrier disruption which exceeded that caused by cells obtained from healthy
controls both kinetically and quantitatively. LA-1 protected barrier function in
the absence and presence of fMLP which served as a secondary stimulant to cause
maximal loss of barrier function. LA-1 protection was also observed by
quantifying collagen exposure underlying endothelial cells challenged with
fMLP-stimulated neutrophils. LA-1 treatment resulted in decreased migration
dynamics of neutrophils crawling on an endothelial monolayer with reduced speed
(?m/s?=?0.25?±?0.01 vs. 0.06?±?0.01, p?0.05), path length (?m?=?199.5?±?14.3
vs. 42.1?±?13.0, p?0.05), and displacement (?m?=?65.2?±?4.7 vs. 10.4?±?1.3;
p?0.05). CONCLUSION: Neutrophils from patients with trauma or sepsis cause
endothelial barrier disruption to a similar extent relative to each other. The
CR3 agonist LA-1 protects endothelial barrier function from damage caused by
neutrophils obtained from both populations of critically ill patients even when
exposed to secondary stimulation.