Am. J. Respir. Crit. Care Med., Vol 149, No. 6, 06 1994, 1526-1533.
Neutrophil sequestration in lungs removed at surgery. The effect of microscopic emphysema
C Selby, E Drost, M Gillooly, E Cameron, D Lamb and W MacNee
Department of Medicine and Thoracic Surgery, City Hospital, Edinburgh, Scotland, U.K.
Neutrophils within the lungs are considered to play an important role in
the pathogenesis of pulmonary emphysema. We have studied the intravascular
distribution of reinjected autologous 111In-labeled neutrophils in lung
specimens resected 10 min after reinjection from 10 patients undergoing
surgery for peripheral bronchogenic tumors. An excess of neutrophils
relative to that expected for the 99mTc-labeled erythrocyte blood volume
was confirmed in all specimens (range, 3- to 136-fold). In seven specimens
which were completely examined, this excess displayed a skewed
distribution, with a median neutrophil sequestration of 20-fold excess, and
correlated with local blood volume (r = -0.51; p < 0.001). There was
also a significant correlation between alveolar wall surface area per unit
volume of lung (AWUV) and neutrophil excess, when randomly selected tissue
blocks from each specimen were analyzed (r = 0.34, n = 51, p = 0.012). This
same trend was demonstrated when whole specimen median values were
considered (r = 0.64, n = 7, p = 0.07). Thus in areas of the lungs with
lower AWUV values (increasing microscopic emphysema), fewer neutrophils
were present. These studies add further support to the view that emphysema
per se is not associated with an increased sequestration of pulmonary
intravascular neutrophils.
