In vivo neutrophil delivery to inflammatory sites in surgical patients. Correlation with in vitro neutrophil chemotaxis and adherence
J. S. Morris, J. L. Meakins and N. V. Christou
We examined the interrelationships between leukocyte adherence (ADH),
polymorphonuclear neutrophil (PMN) chemotaxis (CTX), and PMN delivery to an
inflammatory focus in hospitalized patients. Patients included 25 men and
17 women, with a mean age of 62.8 years, who were admitted for major
elective surgery. The patients were studied preoperatively and on the
second and seventh postoperative days. Leukocyte adherence increased on the
second postoperative day (82.3%, P less than .05) and remained elevated on
the seventh postoperative day (81.6%). Polymorphonuclear neutrophil
chemotaxis decreased significantly on the second postoperative day (3.4 to
2.9 cm, P less than .05), but returned to normal by the seventh
postoperative day. The PMN delivery to skin-window chambers decreased
markedly on the second postoperative day (1.28 million cells, P less than
.05) with a further decrease on the seventh postoperative day (0.82 million
cells). There was no correlation between in vitro PMN CTX and in vivo cell
delivery. We conclude that major surgery leads to increased ADH, decreased
PMN CTX, and diminished PMN delivery to areas of inflammation. However, a
single measure of PMN function such as in vitro PMN CTX does not, alone,
reflect in vivo PMN delivery to areas of inflammation.