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Age-related differences in response to neutrophil-mediated reperfusion injury in the neonatal piglet heart

Background: Neonatal hearts have altered adhesion molecule interactions in response to ischemia-reperfusion. How this affects myocardial function is unknown. Methods: Isolated, buffer perfused 0- to 2-day (newborn) and 2-week piglet hearts were first subjected to 20-minute global, normothermic ische...

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Published in:Surgery 1998-03, Vol.123 (3), p.294-304
Main Authors: Keller, V.Antoine, Pigott, John D., Flint, Lewis M., Hart, Kevin K., Lefer, David J., Ferrara, John J.
Format: Article
Language:English
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Summary:Background: Neonatal hearts have altered adhesion molecule interactions in response to ischemia-reperfusion. How this affects myocardial function is unknown. Methods: Isolated, buffer perfused 0- to 2-day (newborn) and 2-week piglet hearts were first subjected to 20-minute global, normothermic ischemia, followed by 45 minutes of reperfusion during which 150 × 10 6 newborn or 2-week neutrophils were infused. In some hearts, an antibody to SLe x (CSLEX-1) was infused with neutrophils during reperfusion. Hemodynamic variables, including left ventricular developed pressure (LVDP), were recorded at timed intervals. Neutrophil CD-18, L-selectin, and SLe x contents were measured by flow cytometry. Results: Full recovery of LVDP was observed in newborn hearts receiving newborn or 2-week-old neutrophils. Recovery of LVDP was depressed ( p < 0.01, ANOVA) in 2-week-old hearts receiving 2-week old, not newborn, neutrophils. Infusion of CSLEX-1 in 2-week-old hearts restored LVDP to baseline. Whereas flow cytometry showed higher ( p < 0.01, Student's t test) CD-18 and L-selectin expression on newborn versus 2-week-old neutrophils, newborn neutrophils expressed lower ( p < 0.01) SLe x levels. Conclusions: Initial “loose” neutrophil-endothelial selectin interactions are a necessary prelude to “firm” adhesion and reperfusion injury. Operations performed soon after birth may be better tolerated than when surgery is delayed; anti-SLe x preparations may prove beneficial when performing cardiac procedures on older infants. (Surgery 1998;123:294-304)
ISSN:0039-6060
1532-7361
DOI:10.1016/S0039-6060(98)70182-5