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Spiros A. Stergiopoulos, MD; Julius Gordon, PhD; Nicolas V. Christou, MD, PhD

Arch Surg. 1993;128(1):68-72.

Abstract
• We examined the responses of primed polymorphonuclear neutrophils (PMNs) adhered to vascular endothelium, which can lead to endothelial cell damage as a mechanism of the capillary leak syndrome, the main cause of death in anergic patients. We tested PMNs from (1) preoperative reactive patients, (2) preoperative anergic patients, (3) anergic patients in the surgical intensive care unit, and (4) healthy controls for in vitro adherence and cytotoxicity on cultured human vein endothelial cells. Adherence of PMNs was 12.9%±3.9% in preoperative anergic patients and 13.1%±3.2% in anergic patients in the surgical intensive care unit compared with 9.0%±2.1% in preoperative reactive patients (P<.05). Cytotoxicity was 6.0%±2.8% in preoperative reactive patients, 13.7%±4.1% in preoperative anergic patients, and 14.3%±4.6% in anergic patients in the surgical intensive care unit. The PMNs from preoperative anergic patients were more cytotoxic against human vein endothelial cells when stimulated by Staphylococcus epidermidis or formyl-methionyleucylphenylalanine. We conclude that PMNs from anergic surgical patients adhere more to endothelial cells and can produce increased cytotoxicity that may lead to detrimental results.

(Arch Surg. 1993;128:68-72)

Author Affiliations
From the Departments of Surgery (Drs Stergiopoulos, Gordon, and Christou) and Microbiology and Immunology (Drs Gordon and Christou), McGill University, Montreal, Quebec.

Footnotes
Accepted for publication August 15, 1992.

Presented at the 12th Annual Meeting of the Surgical Infection Society, Los Angeles, Calif, April 10, 1992.

Reprint requests to Royal Victoria Hospital, Room S10.30, 687 Pine Ave W, Montreal, Quebec, Canada H3A 1A1 (Dr Christou).

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ABSTRACT