Am. J. Respir. Crit. Care Med., Volume 156, Number 3, September 1997, 932-938

Effect of Cardiopulmonary Bypass on Cytokine Release and Adhesion Molecule Expression in Alveolar Macrophages
Preliminary Report In Six Cases

MASANORI TSUCHIDA, HIROSHI WATANABE, TAKEHIRO WATANABE, HIROYUKI HIRAHARA, MANABU HAGA, HAJIME OHZEKI, JUNICHI HAYASHI, HARUO MIYAMURA, TATSUHIKO HIRONO, TORU ABO, and SHOJI EGUCHI

Department of Thoracic and Cardiovascular Surgery and Department of Immunology, Niigata University School of Medicine, Asahimachi Niigata; Department of Cardiovascular Surgery, Nagaoka Red Cross Hospital, Nagaoka; and Department of Thoracic Surgery, National Nishi-Niigata Central Hospital, Niigata, Japan

Although recent studies have shown that adhesion molecules on alveolar macrophages are important in a variety of pulmonary diseases, there have been few studies on the phenotypic and functional changes of alveolar macrophages during cardiopulmonary bypass. To investigate the possible role of alveolar macrophages in activating pulmonary immunity during cardiopulmonary bypass, we measured the expression of adhesion molecules on alveolar macrophages and peripheral blood monocytes in patients undergoing cardiopulmonary bypass. Antigens were stained with monoclonal antibodies against adhesion molecules, and the expression of antigens was quantified by flow cytometry as the ratio of specific to nonspecific linear fluorescence. On alveolar macrophages obtained after the release of aortic cross-clamp, macrophages as compared with alveolar macrophages obtained before cardiopulmonary bypass, there was a significant enhancement of CD11a, CD11b, CD11c, and CD18. In addition, alveolar macrophages, but not peripheral monocytes, produced higher levels of TNF- and IL-8 when they were cultured in vitro. A higher expression of CD11 and CD18 on alveolar macrophages and enhanced production of cytokines after release of the aortic cross-clamp may contribute to immune activation in lung by macrophage-lymphocyte interaction.

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