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

Journal of Inflammation

Research

Susan Sutherland¹  Wayne Conrad Liles²  Emmanuel Charbonney³  Michael Glogauer⁴  Ashkan Javid⁴  Claudia Dos Santos⁵  Pablo Perez d’Empaire⁶  Gordon David Rubenfeld⁶  Abhijit Duggal⁶  Ruxandra Pinto⁶  Mary Elizabeth Wilcox⁷ 

[1] Department of Dentistry, Sunnybrook Health Sciences Centre, Toronto, Canada;Division of Allergy and Infectious Disease, University of Washington, Seattle, USA;Division of Critical Care, Department of Medicine, University of Montreal, Montreal, Canada;Faculty of Dentistry, University of Toronto, Matrix Dynamics Group, Toronto, Canada;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;Interdepartmental Division of Critical Care, University Health Network, Toronto, Canada;

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

DOI  :  10.1186/s12950-014-0032-5

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

来源: Springer

【 摘 要 】

BackgroundCardiopulmonary 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).MethodsWe 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.ResultsCPB 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 < 0.001; group 1, median: 1.6×105, Interquartile range [IQR], 1.1×105 - 4.8×105, and group 2, median: 1.9×106, IQR, 8.7×105 - 4.0×106).ConclusionsCPB 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】

CC BY   
© Wilcox et al.; licensee BioMed Central Ltd. 2014