Abstract
Objectives and designWe investigated the effect of balanced (BS) and unbalanced (UBS) solutions in the absence or presence of hydroxyethyl starch (HES) on neutrophil functionality, evaluating the release of matrix metalloproteinase (MMP)-9, myeloperoxidase (MPO), and MMP-8.Materials and methodsNeutrophils were isolated by gradient centrifugation and dextran sedimentation and incubated in BS or UBS without or with HES, in the absence or presence of Interleukin-8 (IL-8) or Lipopolysaccharide (LPS). MMP-9, MPO, and MMP-8 were assayed by commercially available ELISA kits.ResultsThere was not any influence of volume replacement solutions on the release of the enzymes from resting neutrophils. After IL-8 stimulation, the release of MMP-9 was higher in BS than in UBS or RPMI-1640, whereas HES enhanced its release regardless of the composition. After LPS stimulation, the release of MMP-9 was higher in both UBS and BS than RPMI-1640, but HES brought its release back to physiological conditions. No difference was found in the release of MPO and MMP-8 after stimulation with IL-8 or LPS.ConclusionVolume replacement solutions might have an impact on the release of MMP-9 depending on the inflammatory milieu, suggesting that the use of balanced or unbalanced solutions is not a neutral choice.Electronic supplementary materialThe online version of this article (doi:10.1007/s00011-014-0709-5) contains supplementary material, which is available to authorized users.
Highlights
Fluid resuscitation is one of the most important aspects in the management of critically ill patients
Objectives and design We investigated the effect of balanced (BS) and unbalanced (UBS) solutions in the absence or presence of hydroxyethyl starch (HES) on neutrophil functionality, evaluating the release of matrix metalloproteinase (MMP)-9, myeloperoxidase (MPO), and Matrix Metalloproteinase-8 (MMP-8)
Volume replacement solutions might have an impact on the release of Matrix Metalloproteinase-9 (MMP-9) depending on the inflammatory milieu, suggesting that the use of balanced or unbalanced solutions is not a neutral choice
Summary
Fluid resuscitation is one of the most important aspects in the management of critically ill patients. Evidence exists on the influence of different volume replacement regimens on systemic inflammation [1, 2], there are still controversial data regarding their effect on neutrophil functions [3, 4]. Nothing is known about the influence of balanced and unbalanced regimens on the release of Matrix Metalloproteinase-9 (MMP-9), a protease stored in tertiary granules of neutrophils and associated with post-operative complications [5] and worse outcomes during septic shock [6], and on the release of Myeloperoxidase (MPO) and Matrix Metalloproteinase-8 (MMP-8), stored in the primary and secondary granules of neutrophils, respectively. We aimed to investigate the effect of balanced (BS) and unbalanced (UBS) solutions in the absence or presence of hydroxyethyl starch (HES) on the degranulation of neutrophils, by mimicking inflammatory conditions through interleukin(IL)-8 and lipopolysaccharides (LPS) treatments
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