Monocyte chemotaxis and chemotactic cytokine release after exposure to hydroxyethyl starch

Abstract

Hydroxyethyl starch (HES) is commonly used in leukapheresis and infused as an alternative to blood components for the treatment of hypotension due to hemorrhage and trauma. Its prolonged intravascular persistence and retention In tissue raise concerns about possible effects on humoral and cell-mediated immunity and white cell (WBC) locomotion, particularly in volunteer WBC donors or in severel burned evaluated the effect of HES on human mono e migration and chemotaxis and the bioassay was developed to quantitate the neutrophil chemotactic activity of a cytokine generated by mononuclear WBCs stimulated in vitro by phytohemagglutinin or tuberculin protein. The time-and dose-dependent generation of the chemotactic cytokine was not affected by the presence of HES. HES by itself did not induce the generation of this cytokine, nor were human monoc e chemotaxis and spontaneous other investigators, suggest that HES is a safe red cell-sedimenting agent for leukapheresis and an alternative to the use of blood components in shock resuscitation. TRANSFUSION 1992;32:855-860. Individuals with immunologic depression and increased risk for infection. T 1 is study production of antigenand mitoqen-Induced x BC-derived chemotactic cytokine. A migration significantly changed by exposure to H I ! S. These results, with those of Abbrevlatlons: HES = hydroxyethyl starch; MNL(s) = mononuclear leukocyte(8); PHA = phytohemagglutlnln; PPD = purlfled proteln derlvatlve of tuberculin; ABC(s) = red cell(s); WBC(s) = whlte cells(s).HYDROXYETHYLATED STARCHES are branched-chain amylopectin polymers with colloidal properties used to restore intravascular volume in the treatment of hemorrhage, burns, and trauma and commonly used as a red cell (RBC)-sedimenting agent to increase the efficiency of Ieukapheresis. Their use in burn shock resuscitation has shown them to be an effective alternative to blood components.'J Hydroxyethyl starch (HES) is commonly administered to volunteer white cell (WBC) donors, in whom it facilitates a substantial increase in the numbers of neutrophils procured for transfusion purposes. It persists in the circulation for month^.^.^ Its long retention in tissue and its ability to impair reticuloendothelial function in miceS raise concerns about potential adverse effects on the immune systems of healthy, volunteer WBC donors and of bum patients long known to have serious burn-induced impairment of the cell-mediated and humoral immune system6 HES is administered during the immediate care of the patient with severe traumatic injury, a condition associated with impaired elaboration of cytokines by mononuclear leukocytes (MNLs).' Although HES does not seem to interfere with the in vitro function of human platelets and neutrophils8 or the re-after generation of RBCsY9 its effect on lymphocytes and monocytes is unclear. In mice, HES and dextran have been reported to inhibit the clearance of S'Cr-labeled RBCs and SICr-labeled Salmonella enteriiidi~.~ On the other hand, it was found not to suppress host resistance to experimentally ...

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“…In an in vitro study Sillet et al [104] demonstrated that T cell activation and mitogenic responses are not inhibited in the presence of dextran, gelatin or HES, implying no immunodepression by colloidal resuscitation fluids. The timeand dose-dependent generation of a chemotactic cytokine was not affected by the presence of HES [105]. HES by itself did not induce cytokine generation, nor were chemotaxis and spontaneous migration of human monocytes affected [105].…”

“…The timeand dose-dependent generation of a chemotactic cytokine was not affected by the presence of HES [105]. HES by itself did not induce cytokine generation, nor were chemotaxis and spontaneous migration of human monocytes affected [105].…”

Der Einfluss verschiedener Volumenersatzmittel auf die Funktion von neutrophilen Granulozyten in vitro

“…Nach der Gabe von kolloidalen Volumenersatzmitteln werden diese in verschiedenen Organsystemen [5,10,20] …”

High doses of hydroxyethyl starch and human albumin have similar effects on monocyte function and oncotic pressure

“…However, small amounts of HES are taken up by monocytes/macrophages, particularly in the liver and spleen [2,3], raising the possibility of detrimental effects. Studies involving healthy volunteers have confirmed the lack of detrimental effects on chemotaxis and phagocytosis [10][11][12]. Studies involving healthy volunteers have confirmed the lack of detrimental effects on chemotaxis and phagocytosis [10][11][12].…”