Document Detail


Complement activation during cardiopulmonary bypass: evidence for generation of C3a and C5a anaphylatoxins.
MedLine Citation:
PMID:  7453783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We observed complement activation in 15 adults undergoing total cardiopulmonary bypass. Plasma levels of C3a were significantly elevated (P < 0.0001) at the beginning of the procedure, and they continued to increase steadily thereafter. At the end of the procedure, C3a levels were more than five times higher than preoperative levels. Plasma levels of C5a (a factor that binds avidly to neutrophils) did not change significantly during cardiopulmonary bypass. Instead, there was significant neutrophilia (P = 0.03) during bypass, and significant transpulmonary neutropenia (P = 0.0002) occurred when cardiopulmonary circulation was reestablished at partial bypass. The neutropenia is consistent with pulmonary-vascular sequestration of C5a-activated granulocytes. We also found that incubation of blood with the nylon-mesh liner of bubble oxygenators, as well as vigorous oxygenation of whole blood, promotes conversion of complement. We conclude that the complement-derived inflammatory mediators C3a and C5a produced during extracorporeal circulation may contribute to the pathogenesis of "post-pump syndromes."
Authors:
D E Chenoweth; S W Cooper; T E Hugli; R W Stewart; E H Blackstone; J W Kirklin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  304     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1981 Feb 
Date Detail:
Created Date:  1981-03-27     Completed Date:  1981-03-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  497-503     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anaphylatoxins / biosynthesis*
Complement Activation*
Complement C3 / analysis*
Complement C5 / analysis*
Humans
Leukocyte Count
Middle Aged
Neutropenia / etiology
Nylons / adverse effects
Oxygenators / adverse effects,  instrumentation
Peptide Biosynthesis*
Grant Support
ID/Acronym/Agency:
HL 11310/HL/NHLBI NIH HHS; HL 25658/HL/NHLBI NIH HHS; HL 96411/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anaphylatoxins; 0/Complement C3; 0/Complement C5; 0/Nylons

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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