“…The mechanisms responsible for this phenomenon are presently unknown. Since endotoxin and fMLP possess similar granulocyte activating potencies [3], we suggest that endotoxin-induced endothelial damage may play an essential role: if fMLP-activated, hyperadhesive [4] granulocytes encounter endothelial cells that have been injured by endotoxin (an injury that does not occur with fMLP alone), the result is a deleterious sequence of events (e.g., persistent neutropenia; see table). In contrast, if granulocytes activated by either endotoxin or fMLP encounter native, undamaged endothelium, subsequent alterations remain limited.…”