Increased incidence of septic complications in human and experimental portal hypertension has been documented. Because development of an inflammatory response is essential in defense against infectious agents, the aim of this study was to assess leukocyte-endothelial cell interactions in an experimental model of portal hypertension. Intravital microscopy studies showed that under baseline conditions, leukocyte rolling, adhesion, and emigration in mesenteric venules were similar in control, sham operated (SO), and partial portal vein ligated (PPVL) rats. Compared with either control or SO rats, PPVL animals exhibited a markedly reduced recruitment of rolling, adherent, and emigrated leukocytes in response to leukotriene B 4 (LTB 4 ) stimulation. Similarly, platelet-activating factor (PAF) superfusion, which induced a large increment in leukocyte rolling and adherence in control and SO rats, was without any effect in PPVL animals. Endothelial P-selectin expression in control rats, as measured by the double radio-labeled monoclonal antibody (mAb) technique, was not modified by LTB 4 , but significantly increased in response to PAF. PPVL rats had a significantly lower expression of P-selectin after stimulation with PAF. Neutrophils isolated from PPVL rats exhibited increased L-selectin shedding and CD11b up-regulation in response to PAF and LTB 4 , compared with neutrophils isolated from SO rats. These observations indicate that portal hypertension is associated with a defective inflammatory response, which is manifested as a decreased recruitment of rolling leukocytes, and subsequently reduced adhesion/emigration. This defect appears to result from a reduced endothelial P-selectin up-regulation and increased L-selectin shedding. (HEPATOLOGY 1999;30:445-453.)Patients with liver disease and portal hypertension are predisposed to develop spontaneous infections by enteric bacteria. These infective sequelae are responsible for serious and often fatal complications; however, the mechanism(s) underlying this high incidence of infection-related complications is not completely understood. One potential contributing factor is impaired neutrophil function. Neutrophilic superoxide anion production and the generation of both platelet-activating factor (PAF) and leukotriene B 4 (LTB 4 ) are reduced in alcohol-related 1 and non-alcohol-related cirrhosis. 2 In addition, demonstration of bacterial translocation to mesenteric ganglia in animal models of portal hypertension without liver disease 3,4 and the appearance of a unique septic complication such as spontaneous bacterial peritonitis in human cirrhosis with portal hypertension 5 suggest that there is a deficient host immune response in the mesenteric circulation directly related to portal hypertension.The adhesion of leukocytes to vascular endothelial cells is a critical early step in the development of an inflammatory response. This process is essential in isolating and eliminating infectious agents and in tissue repair. The inflammatory response involves sequential leukocyte...