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Eur J Cardiothorac Surg 1999;15:408-412
© 1999 Elsevier Science NL

Endothelin-1 is involved in plasma mediated stimulation of neutrophil adherence during coronary artery bypass grafting

Pawe Bugajski^a, Ryszard Kalawski^a, Izabella urawska^b, Marek Bartkowiak^a, Henryk Wysocki^b, Roman Olszewski^a, Tomasz Siminiak^a,b

^a Department of Cardiosurgery, J. Strus Hospital Poznan, Poznan, Poland
^b Department of Cardiology and Intensive Therapy, Karol Marcinkowski University of Medical Sciences, ul. Przybyszewskiego 49, PL 60-355 Poznan, Poland

Received 30 July 1998; received in revised form 8 January 1999; accepted 19 January 1999.

Corresponding author. Tel.: +48-61-869-1394; fax: +48-61-867-1232.

Objective: Myocardial ischaemia followed by reperfusion during coronary artery bypass grafting (CABG) is known to result in the activation of polymorphonuclear neutrophils (PMN). The activation of PMN during ischaemia/reperfusion may be a result of their direct contact with activated endothelial cells and/or an effect of stimuli released from ischaemic myocardium. Increased expression of adhesion molecules on the PMN surface, after activation, leads to coronary capillary plugging with a subsequent decrease in blood flow. The purpose of the study was to evaluate plasma-mediated stimulation of PMN adhesion during CABG and to verify if endothelin-1 (ET-1), known to be a potent stimulus for PMN, is involved in stimulation of neutrophils adhesion mediated by integrins. Methods: Coronary sinus, peripheral artery and peripheral venous plasma samples were taken from 11 patients undergoing coronary surgery before aortal cross-clamping, at the beginning of reperfusion and 30 min thereafter. PMN isolated from five healthy volunteers were incubated with the plasma (20 samples per patient) in the presence of saline or a specific ET-1 receptor blocker, and PMN adherence to a microtiter plate covered with a monoclonal antibody against CD 18 antigen (ß-subunit of the integrin family of adhesion molecules) was evaluated. Results: We have observed a significant increase in adhesion of PMN incubated in the presence of saline with the plasma taken from coronary sinus at the beginning of reperfusion (7.79±1.64% of adhering cells) as compared with plasma obtained before aortal cross-clamping from the same place (6.78±1.3%, P=0.04) and from peripheral artery at the beginning of reperfusion (6.64±1.1%, P=0.04, means±SEM). ET-1 receptor blocker, significantly decreased stimulation of PMN adhesion by coronary sinus plasma obtained at the beginning of reperfusion (6.7±1.51%, P=0.02). Plasma levels of ET-1 (ELISA) in the samples taken from coronary sinus at the beginning of reperfusion, were higher than in samples obtained before myocardial ischaemia or 30 min after reperfusion. Conclusions: We conclude, that soluble stimuli capable of stimulation of PMN adhesion are released following myocardial ischaemia during CABG and ET-1 may be involved in PMN stimulation.

Key Words: Coronary artery bypass • Endothelin • Neutrophil

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