Oral neutrophils are an independent marker of the systemic inflammatory response after cardiac bypass

Journal of Inflammation

Michael Glogauer⁶  Wayne Conrad Liles³  Susan Sutherland⁷  Gordon David Rubenfeld⁵  Claudia Dos Santos⁴  Ashkan Javid⁶  Ruxandra Pinto⁵  Abhijit Duggal⁵  Pablo Perez d¿Empaire⁵  Emmanuel Charbonney¹  Mary Elizabeth Wilcox² 

[1] Division of Critical Care, Department of Medicine, University of Montreal, Montreal, Canada;Interdepartmental Division of Critical Care, University Health Network, Toronto, Canada;Division of Allergy and Infectious Disease, University of Washington, Seattle, USA;Interdepartmental Division of Critical Care, St. Michael¿s Hospital, Keenan Research Centre of Li Ka Shing Knowledge Institute, Toronto, Canada;Interdepartmental Division of Critical Care, Trauma, Emergency and Critical Care Program, Sunnybrook Health Sciences Centre, Toronto, Canada;Faculty of Dentistry, University of Toronto, Matrix Dynamics Group, Toronto, Canada;Department of Dentistry, Sunnybrook Health Sciences Centre, Toronto, Canada

关键词: Neutrophil activation;    Critical illness;    Coronary bypass;    Multiple organ failure;    Biomarkers;   

Others  :  1140763
DOI  :  10.1186/s12950-014-0032-5

 received in 2013-11-18, accepted in 2014-10-03,  发布年份 2014

【 摘 要 】

Background

Cardiopulmonary bypass (CPB) is an immuno-reactive state where neutrophils are activated and accumulate in different tissues. Edema and tissue necrosis are the most common sequelae observed, predominantly in the lungs, kidneys, and heart, heralding significant risk for postoperative complications. No method exists to noninvasively assess in vivo neutrophil activity. The objective of this study was to determine if neutrophil recruitment to the oral cavity would correlate with specific biomarkers after coronary bypass surgery (CPB).

Methods

We conducted a single site prospective observational study including non-consecutive adult patients undergoing elective, on-pump CPB. Blood and either oral cavity rinses or swabs were collected pre- and post-CPB. Absolute neutrophil counts from oral samples and serum biomarkers were measured. The association between neutrophil recruitment to the oral cavity, biomarkers and outcomes after CPB were analyzed.

Results

CPB was associated with statistically significant increases in oral and blood neutrophil counts, as well as an increase in certain biomarkers over preoperative baseline. Peripheral blood neutrophil count were increased at all time points however statistically significant differences in median oral neutrophil counts were observed only at the time point immediately postoperative, and in what seems to be two unique patient populations (p?5, Interquartile range [IQR], 1.1×10⁵ - 4.8×10⁵, and group 2, median: 1.9×10⁶, IQR, 8.7×10⁵ - 4.0×10⁶).

Conclusions

CPB is associated with a transient increase in oral neutrophils that may correlate with the systemic inflammatory response; oral neutrophils may have the ability to discriminate and identify unique patient populations based on their tissue migration.

【 授权许可】

   
2014 Wilcox et al.; licensee BioMed Central Ltd.

【 图 表 】

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