Band Cell Counts Research Articles

Hematological and coagulation parameters as predictors of death by Coronavirus disease in hospitalized patients: a Brazilian follow-up study

This study aimed to evaluate the hematological and coagulation parameters according to the clinical outcomes of coronavirus disease (COVID-19). We analyzed the hematological and coagulation parameters of hospitalized patients with COVID-19 at admission, and two and three weeks during hospitalization. To assess the performance of these parameters in predicting poor outcomes, receiver operating characteristic (ROC) curves were created. We studied 128 patients with COVID-19 (59.2±17.7 years, 56% male). Non-survivors (n=54, 42%) presented significant alterations in hematological and coagulation parameters at admission, such as increased in white blood cells (WBC), neutrophil, and band cell counts, as well as elevated prothrombin time (PT), activated partial thromboplastin time, and D-dimer levels. During follow-up, the same group presented a gradual increase in D-dimer and PT levels, accompanied by a reduction in PT activity, hemoglobin, and red blood cell count (RBC). ROC curves showed that WBC, neutrophil, and band cell counts presented the best area under the curve (AUC) values with sensitivity and specificity of >70%; however, a logistic regression model combining all the parameters, except for RBC, presented an AUC of 0.89, sensitivity of 84.84%, and specificity of 77.41%. Our study shows that significant alterations in hematological and coagulation tests at admission could be useful predictors of disease severity and mortality in COVID-19.

Comparison of the diagnostic accuracy of markers of the acute phase of inflammation in cats. A preliminary evaluation

Markers of acute inflammation are gaining broader acceptance in feline veterinary practice but the criteria of their diagnostic accuracy have mostly not been determined. The goal of this study was to compare the diagnostic accuracy of a variety of markers of inflammation that can be rapidly measured in everyday veterinary practice settings. White blood cell, as well as neutrophil and band cell count, degree of toxic neutrophilia, total proteins, albumin, albumin-to-globulin ratio, fibrinogen, and serum amyloid A protein were measured in 35 cats with acute inflammatory diseases and 16 control cats. The sensitivity, specificity, and receiver operating curves of these markers were then compared. The markers with the highest sensitivities and specificities, as well as areas-under-the-curve of the receiver operating curves > 0.9, were fibrinogen, serum amyloid A, degree of toxic neutrophilia, and albumin-to-globulin ratio. The correlations between the different markers were, with the exception of fibrinogen and SAA, low. SAA, fibrinogen, albumin-to-globulin ratio are a panel of sensitive inflammatory biochemistry biomarkers easily available for non specialist veterinarians improving the rapidity of feline patient assessment.

Influence of starvation and transportation on serum galanin and hematobiochemical parameters in goats

This study was performed to evaluate the effect of starvation and transportation on hematological parameters and serum concentrations of galanin, triglyceride, total cholesterol, HDL and LDL-cholesterol in goats. On the first day, first and second blood samples from ten Cashmere (Raini) goats (5 males and 5 non-lactating and non-pregnant females) were prepared before food and water deprivation at 8:00 a.m. (T1) and 3 h after food and water deprivation (T2) at 11:00 a.m., respectively. On the second day, third and fourth blood samples were collected before transportation at 8:00 a.m. (T3) and 3 h after transportation (T4) at 11:00 a.m., respectively. Final blood samples were taken 24 h after arrival (T5). No significant difference was found between the male and female goats in the measured serum parameters, except galanin. Serum concentration of galanin showed a significant increment due to the starvation followed by a decrement in males and an increment in females. Food and water deprivation caused a significant increment in neutrophil and band cell counts besides a significant decrement in lymphocyte, monocyte, and eosinophil counts. Transport stress caused a significant decrease in packed cell volume (PCV) and white blood cell (WBC) and lymphocyte counts as well as a significant increment in neutrophils and band cells counts. It seems that besides interspecies difference, the condition of transportation was the main cause for the controversial findings about its effects on physiology and health of animals.

Short Term Oral Zinc Supplementation among Babies with Neonatal Sepsis for Reducing Mortality and Improving Outcome - A Double-Blind Randomized Controlled Trial.

To evaluate the efficacy of short term zinc supplementation on the mortality rate and neurodevelopment outcome in neonates with sepsis at 12 mo corrected age. The clinical trial was undertaken in the neonatal intensive care unit of JIPMER during the time period from September 2013 through December 2016. Neonates with clinical manifestations of sepsis who exhibited two positive screening tests (microESR, C- reactive protein, band cell count) were included and randomized into no zinc and zinc group. The intervention was zinc sulfate monohydrate given at a dose of 3mg/kg twice a day orally for 10 d along with standard antibiotics. The no zinc group was on antibiotic treatment. Blood samples from both groups were collected at baseline and after day 10. Babies were carefully discharged from the hospital. The babies were followed up till 12mo corrected age using DASII (Development Assessment Scale for Indian Infants). At the time of enrolment, patient characteristics were similar in both the groups. The mortality rate was significantly higher in no zinc compared to zinc group (5 vs. 13; P=0.04). Although motor development quotient was similar, mental development quotient was significantly better among babies who received zinc supplementation. Short term zinc supplementation of newborns with sepsis reduces mortality and improves mental development quotient at 12 mo of age.

Evaluation of serum chemokine RANTES concentration as a biomarker in the diagnosis of early-onset severe infections in neonates.

Only a few studies on improving the early diagnosis of severe neonatal infections have focused on the role of serum RANTES concentration (sRC). The aim of the study was to establish sRC in neonates with early-onset infections, according to their gestational age, sex, birth asphyxia, mode of delivery and value of some biochemical and hematological parameters. The analysis comprised 129 neonates, including 89 infected (52 preterm, 37 full-term; 43 with sepsis, 39 with congenital pneumonia, 7 with severe urinary tract infection) and 40 healthy (control group, 25 full-term, 15 preterm). The sRC in peripheral vein blood was measured by the ELISA method using Quantikine Set (R & D systems, USA). The sRC in infected neonates ranged from 10.83 to 122.55 μg/ml, in full-term neonates from 18.28 to 122.55 μg/ml, and in preterm from 10.83 to 118.24 μg/ml. The mean sRCs in full-term septic neonates (73.95±25.99 μg/ml) and with organ infections (58.43±29.24 μg/ml) were significantly higher than healthy ones (28.25±14.06 μg/ml). The mean sRCs in septic preterm neonates (59.17±28.29 μg/ml) and those with organ infections (50.86±28.16) were significantly higher than in healthy preterm neonates (25.61±8.29 μg/ml). Positive correlations between sRC and CRP value (r=0.3014, p=0.004) and between sRC and band cell count (r=0.2489, p=0.019) were found in all infected neonates. The significant increase of serum RANTES concentration in early-onset infections in neonates, regardless of their gestational age, sex and birth asphyxia, not only proves the presence of an active immunological process but also may be a useful biomarker for diagnosis of severe neonatal infections.

Correlation of blood culture and band cell ratio in neonatal septicaemia.

Background: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteraemia in the first month of life. Incidence differs among hospitals depending on variety of factors. Blood culture is considered gold standard for the diagnosis, but does not give a rapid result. Hence, there is a need to look for a surrogate marker for diagnosing neonatal septicaemia. Material & Methods: 335 neonates were studied for clinically suspected septicaemia over a period of one year. Blood was cultured and organism identified biochemically. Parameters of subjects like EOS, LOS and Band cell counts were recorded. Results analysed statistically. Results: Male preponderance was observed. Majority of the cases had a normal vaginal delivery. 47.46% cases had early onset septicaemia. Meconium stained liquor was the predominant risk factor .Culture positivity was found to be 32.24% and 87.96% of them also had band cells percentage ranging from 0 to >25. Conclusion: Band cell count can be used as a surrogate marker for neonatal septicaemia. An upsurge of Candida species as a causative agent in Neonatal septicaemia has been observed.

Systemic and vascular effects of circulating diesel exhaust particulate matter

Objective: Numerous studies have found an association between transiently increased particulate matter air pollution and acute adverse cardiovascular health effects; however, the mechanisms underlying these effects are not clear. Translocation of ultra-fine ambient particulate matter has been proposed to play a key role in these acute side effects. This study was designed to determine the contribution of circulating (translocated) diesel exhaust particles (DEPs) to the systemic and vascular effects.Methods: C57 mice (10-week) received intravenous DEPs via tail vein injection. Following 1-h post-injection, inflammatory cytokines (IL-1β, IL-6 and TNF-α), peripheral blood cell counts, band cell counts, aortic endothelial function and vascular constriction were assessed. Thoracic aortae were isolated, and endothelial function was examined by measuring acetylcholine (ACh) and sodium nitroprusside (SNP)-stimulated vascular relaxation using a wire myograph. In addition, phenylephrine (PE)-stimulated vasoconstriction was also measured. The amount of DEPs deposited and trapped in tissues (the spleen, liver, lungs and heart) were quantified.Results: Acute systemic DEP exposure caused a significant increase in TNF-α, peripheral neutrophil and band cell counts. ACh and SNP-induced relaxation were not affected by acute systemic DEP exposure, neither was PE-stimulated constriction. There was a significantly increased DEP deposition in the spleen as well as in the liver. No significantly increased DEPs were detected in the lung and heart.Conclusion: Here we show that circulating DEPs induce a systemic response characterized by increased TNF-α, peripheral granulocytes, but does not impact endothelial function. Our study also suggests that circulating particles are rapidly removed from the circulation and predominantly sequestered in the spleen and liver.

The Future Possibilities of Diagnostic Testing for the Evaluation of Febrile Infants

The Future Possibilities of Diagnostic Testing for the Evaluation of Febrile Infants

Necrotizing fasciitis of the extremities: a prospective study

Necrotizing fasciitis is a rapidly progressive infection and is a necrosis of the fascia and surrounding tissues. Despite recent advances in its management, outcomes have not improved and mortality rate is still high. Between September 2007 and August 2009, we prospectively studied twenty-four histopathologically proven necrotizing fasciitis patients to assess the prognostic factors that indicate the outcome. Mortality rate was 20.8%. Twelve patients (50%) improved, while seven patients (29.2%) were complicated by limb loss. Mortality rates related to upper and lower limb involvement were similar (20% vs. 22.2%). The rates of gangrene and amputation in patients with diabetes mellitus were significantly higher than other comorbidities. Patients with gram-positive infections had significantly lower rates of amputation (15.4% vs. 54.5%, P = 0.04). Mean band cell count and serum potassium level were significantly higher in the nonsurvivors same as leukocyte count in the patients with gangrene, while serum sodium level was significantly lower in nonsurvivors. We conclude that hyponatremia, hyperkalemia, and increased band cells in the peripheral blood of patients may be useful parameters in distinguishing life-threatening necrotizing fasciitis; hence, we recommended lower threshold to amputation during surgery for this group of patients.

An Air Filter Intervention Study of Endothelial Function among Healthy Adults in a Woodsmoke-impacted Community

Particulate air pollution is associated with cardiovascular morbidity. One hypothesized mechanism involves oxidative stress, systemic inflammation, and endothelial dysfunction. To assess an intervention's impact on particle exposures and endothelial function among healthy adults in a woodsmoke-impacted community. We also investigated the underlying role of oxidative stress and inflammation in relation to exposure reductions. Portable air filters were used in a randomized crossover intervention study of 45 healthy adults exposed to consecutive 7-day periods of filtered and nonfiltered air. Reactive hyperemia index was measured as an indicator of endothelial function via peripheral artery tonometry, and markers of inflammation (C-reactive protein, interleukin-6, and band cells) and lipid peroxidation (malondialdehyde and 8-iso-prostaglandin F(2α)) were quantified. Air filters reduced indoor fine particle concentrations by 60%. Filtration was associated with a 9.4% (95% confidence interval, 0.9-18%) increase in reactive hyperemia index and a 32.6% (4.4-60.9%) decrease in C-reactive protein. Decreases in particulate matter and the woodsmoke tracer levoglucosan were associated with reduced band cell counts. There was limited evidence of more pronounced effects on endothelial function and level of systemic inflammation among males, overweight participants, younger participants, and residents of wood-burning homes. No associations were noted for oxidative stress markers. Air filtration was associated with improved endothelial function and decreased concentrations of inflammatory biomarkers but not markers of oxidative stress. Our results support the hypothesis that systemic inflammation and impaired endothelial function, both predictors of cardiovascular morbidity, can be favorably influenced by reducing indoor particle concentrations.

Hematologic effects of subcutaneous administration of recombinant human granulocyte colony-stimulating factor (filgrastim) in healthy alpacas

To determine the effects of SC administration of filgrastim on cell counts in venous blood and bone marrow of healthy adult alpacas. 10 healthy alpacas. Alpacas were randomly assigned to receive treatment with filgrastim (5 microg/kg, SC; n=5) or an equivalent volume of physiologic saline (0.9% NaCl) solution (5) once a day for 3 days. Blood samples were obtained via jugular venipuncture 1 day prior to treatment and once a day for 5 days commencing 24 hours after the first dose was administered. Complete blood counts were performed for each blood sample. Bone marrow aspirates were obtained from the sternum of each alpaca 48 hours before the first treatment was administered and 72 hours after the third treatment was administered. Myeloid-to-erythroid cell (M:E) ratio was determined via cytologic evaluation of bone marrow aspirates. In filgrastim-treated alpacas, substantial increases in counts of WBCs and neutrophils were detected within 24 hours after the first dose was administered. Band cell count and percentage significantly increased 24 hours after the second dose. Counts of WBCs, neutrophils, and band cells remained high 48 hours after the third dose. Red blood cell counts and PCV were unaffected. The M:E ratio also increased significantly after treatment with filgrastim. Filgrastim induced rapid and substantial increases in numbers of circulating neutrophils and M:E ratios of bone marrow in healthy alpacas. Therefore, filgrastim may be useful in the treatment of camelids with impaired bone marrow function.

Release of band cells from the bone marrow is impaired by preoperative chemoradiation in patients with esophageal carcinoma: increased risk of postoperative pneumonia

To examine the difference in hematological data and postsurgical course after esophagectomy between patients receiving preoperative chemoradiation and patients without preoperative treatment. Twenty-two patients with squamous cell carcinoma of the esophagus who underwent esophagectomy during the past 2 years were retrospectively analyzed in the study. Six patients had preoperative chemoradiation (CRT group) and 16 patients had no preoperative treatment (non-CRT group). The hematological data, postoperative course, and surgical complications were compared between the two groups. Patients in the CRT group were given cisplatin and 5-FU (143 and 6,000 mg on average, respectively) plus an average of 35 Gy of radiation. Although the neutrophil count did not show a significant difference between the two groups, the band cell count was lower in the CRT group compared with the non-CRT group on postoperative day 1 (P<0.05). Postoperative pneumonia was detected in three patients (50%) from the CRT group versus none of the non-CRT group. Preoperative CRT may be a risk factor for postoperative pneumonia in patients with esophageal carcinoma who undergo esophagectomy. The normal bone marrow response of releasing band cells from the postmitotic marrow pool after surgery could be disturbed by CRT, which might contribute to an increase in later pulmonary complications.

Granulocytosis and increased adhesion molecules after resistive loading of the diaphragm

Upregulation of endothelial cell adhesion molecules, followed by an influx of granulocytes and macrophages, can contribute to exertion-induced skeletal muscle injury. The purpose of this study was to quantify circulating leukocyte subsets, diaphragm injury and infiltrating leukocyte subsets, and surface expression of vascular cell adhesion molecule (VCAM)-1 and intracellular adhesion molecule (ICAM)-1 in the diaphragm after inspiratory resistive loading (IRL). Eight New Zealand white rabbits underwent 1.5 h of IRL and seven control rabbits underwent a sham procedure. Blood samples, taken at baseline and 2, 6, 12, 24, 48 and 72 h after the onset of IRL or sham, showed that band cell counts had increased at 6 h post-IRL. Point counting of haematoxylin and eosin-stained cross-sections, sampled at 72 h post-IRL, showed greater injury in diaphragms from IRL rabbits compared with controls. Immunohistochemical processing showed increased expression of ICAM-1 and VCAM-1, and higher granulocyte and macrophage counts in IRL diaphragms than control diaphragms. Macrophages were the predominant inflammatory cells. Increased intracellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression, and infiltration of granulocytes and macrophages may contribute to inspiratory resistive loading-induced diaphragm injury.

Particulate matter air pollution stimulates monocyte release from the bone marrow.

Particulate air pollution (PM(10)) stimulates alveolar macrophages (AMs) to release immature granulocytes from the bone marrow (BM) into the circulation. This study was designed to determine the effect of PM(10) (ambient EHC-93 or inert carbon [CC]) instillation exposure on the monocyte release from the BM and the role of AM in this response. Monocyte precursors were labeled in the BM of rabbits in vivo by an intravenous injection of 5'-bromo-2'-deoxyuridine, and the effects of PM(10) were determined by instillation either particles or supernatants of AM exposed to particles into the lungs. Instillation of EHC-93 (500 microg/ml) or supernatants from AM incubated with EHC-93 (100 microg/ml) increased circulating band cell counts (p < 0.05) and shortened the transit time of monocytes through the BM (35.5 +/- 2.2 to 25.0 +/- 1.5 hours or 36.2 +/- 2.6 to 25.7 +/- 1.8 hours, p < 0.05) compared with the control subject. CC (1%) instillation also shortened the monocyte BM transit time to 28.4 +/- 1.9 hours (p < 0.05), but supernatants of AM incubated with CC did not. We conclude that exposure to atmospheric PM(10) stimulates the production of mediators by AM, and these cytokines accelerate the monocyte release from the BM.

Exposure to ambient particles accelerates monocyte release from bone marrow in atherosclerotic rabbits.

Exposure to air pollution [particulate matter, particles <10 microm (PM(10))] causes a systemic inflammatory response that includes stimulation of the bone marrow (BM) and progression of atherosclerosis. Monocytes are known to play a key role in atherogenesis by migration into subendothelial lesions where they appear as foam cells. The present study was designed to quantify the BM monocyte response in Watanabe heritable hyperlipidemic (WHHL) rabbits after PM(10) exposure. WHHL rabbits were given twice weekly intrapharyngeal instillations of 5 mg of PM(10) for 4 wk to a total of 40 mg and compared with control WHHL or New Zealand White (NZW) rabbits. The thymidine analog 5'-bromo-2'-deoxyuridine was used to label dividing cells in the BM and a monoclonal antibody to identify monocytes in peripheral blood. The transit time of monocytes through the BM was faster in WHHL than in NZW rabbits (30.4 +/- 1.9 h vs. 35.2 +/- 0.9 h, WHHL vs. NZW; P < 0.05). PM(10) instillation exposure increased circulating band cell counts, caused rapid release of monocytes from the BM, and further shortened their transit time through the BM to 23.2 +/- 1.6 h (P < 0.05). The percentage of alveolar macrophages containing particles in the lung correlated with the BM transit time of monocytes (r(2) = 0.45, P <0.05). We conclude that atherosclerosis increases the release of monocytes from the BM, and PM(10) exposure accelerates this process in relation to the amount of particles phagocytosed by alveolar macrophages.

Automated flagging influences the inconsistency and bias of band cell and atypical lymphocyte morphological differentials.

This study evaluated inter- and intra-observer variabilities of band cell and atypical lymphocyte differentials and the influence of instrument flagging information on resulting microscopic differentials. Five stained slides with a range of band cell counts and five with variable numbers of atypical lymphocytes were sent for morphological review by 30 technicians. No supplementary full blood cell count information was provided. Two months later, the same slides were sent, together with their corresponding analyzer reports comprising the full blood cell count, automated differentials and flags, to the same technicians. The first and second appraisals of band cells and variant lymphocytes both showed poor levels of inter-observer consistency. Observed values for all slides were very wide and suggested a high inherent predisposition to erroneous reporting practices. Analysis of category trends showed that analyzer left shift or immature granulocytes flags had no influence on observer band cell assessments as downward vs. upward category revisions were evenly balanced. The findings for atypical lymphocytes were, however, somewhat different. Two slides with no flags both showed balanced category revisions, whereas two of the three slides with atypical lymphocyte flags showed clear evidence of upward category revision. The third slide with an atypical lymphocyte flag did not show any overall category trend, but six of the seven observers who in the first examination recorded atypical lymphocyte estimates of < or = 30% revised their estimates upward when the slides were examined the second time. These results suggest that morphologist access to an analyzer report and flagging information is unlikely to affect the "randomness" of band cell determinations but it may induce observer bias in variant lymphocyte estimates.

THE EFFECTS OF PROLONGED EXERCISE IN A HOT ENVIRONMENT ON NEUTROPHIL DEGRANULATION IN TRAINED CYCLISTS

PURPOSE To examine the influence of a prolonged bout of exercise in hot and humid conditions on neutrophil degranulation, activation status and band cell count. METHODS On two occasions, in random order and separated by one week, six well trained male cyclists reported to the laboratory at 1230 h following a 4 h fast. Subjects cycled for 2 h on a stationary ergometer at 55% peak power output (186 ± 5 W, mean ± SEM) in an environmental chamber on one occasion (HOT: 29.8°C, 79% RH) and on another occasion (CONTROL: 19.4°C, 68% RH). Venous blood samples were collected at pre, post and 2 h post-exercise. Neutrophil expression of CD11b (a marker of neutrophil activation status) was determined using flow cytometry. Band (immature) neutrophil count was determined microscopically on blood smears. Elastase released from lipopolysaccharide (LPS)-stimulated neutrophils (degranulation) and the plasma cortisol concentration were determined using ELISA. RESULTS The increase in exercising heart rate, rating of perceived exertion and rectal temperature was greater during HOT (P < .05). Plasma cortisol increased post-exercise (P < .01) with no difference between trials. A marked neutrophilia was evident at post-exercise and 2 h post-exercise (P < .01) with no difference between trials. Neutrophil CD11b expression increased post-exercise but this did not reach significance (P < .06). There was no effect of exercise or trial on the percentage of band neutrophils. LPS-stimulated elastase release per neutrophil decreased post-exercise (P < .01) similarly on both trials. CONCLUSION These data suggest that prolonged exercise results in a decrease in neutrophil degranulation that is unaffected by performing the exercise in hot and humid conditions. Also, the decrease in neutrophil degranulation after prolonged exercise is not associated with changes in the percentage of band neutrophils.

Effects of Pneumoperitoneum on Hemodynamic and Systemic Immunologic Responses to Peritonitis in Pigs

Background. Experimental evidence supporting the safety of laparoscopic intervention during sepsis is limited. The purpose of this study was to evaluate the effects of pneumoperitoneum on immunologic and hemodynamic responses to peritoneal sepsis. Materials and methods. A porcine model of peritonitis was created using an intraperitoneal autologous fecal inoculum. Pigs were then subjected to one of four procedures 24 h postinoculation ( n = 6 per group): laparotomy, CO 2 laparoscopy, helium laparoscopy, and anesthesia only (1.5% isoflurane in 100% O 2, mechanical ventilation). Venous blood samples were obtained prior to inoculation, and at 24 (prior to procedure), 30, 48, 72, and 96 h postinoculation to determine white blood count (WBC) with differential, C-reactive protein (CRP), tumor necrosis factor, and bacteremia. Heart rate, end-tidal CO 2 (ETCO 2), mean arterial blood pressure (MAP), and arterial blood gas variables were also measured at baseline and every 30 min throughout the procedure. Results. Postoperative blood cultures confirmed systemic bacteremia in all groups at all time periods postinoculation. Following inoculation, WBC, band cell count, and CRP remained elevated above baseline in all groups throughout the study ( P < 0.01). However, no significant differences in these parameters were observed among groups. In the CO 2 laparoscopy group, MAP, ETCO 2, and arterial pCO 2 were increased above baseline, while pH was decreased throughout the procedure ( P < 0.01). Conclusion. In this animal model of peritonitis, CO 2 pneumoperitoneum induced hypercapnia, acidemia, and systemic hypertension intraoperatively, without a discernable effect on systemic immune function.

Interaction of alveolar macrophages and airway epithelial cells following exposure to particulate matter produces mediators that stimulate the bone marrow.

Exposure to ambient air pollution particles with a diameter of < 10 microm (PM(10)) has been associated with increased cardiopulmonary morbidity and mortality. We postulate that these adverse health effects are related to proinflammatory mediators produced in the lung and released into the circulation where they initiate a systemic inflammatory response. The present study was designed to determine if alveolar macrophages (AMs) and primary human bronchial epithelial cells (HBECs) interact to amplify the production of certain cytokines when exposed to ambient PM(10) (EHC-93). Candidate cytokines were measured at the mRNA level using a RNase protection assay and at the protein level by enzyme-linked immunosorbent assay (ELISA). When AM/HBEC cocultures were exposed to 100 microg/ml of PM(10), levels of tumor necrosis factor (TNF)-alpha, granulocyte macrophage colony stimulating factor (GM-CSF), interleukin (IL)-1beta, IL-6, leukemia inhibitory factor (LIF), oncostatin M (OSM), and IL-8 mRNA increased within 2 h (P < 0.05) and 8 h following exposure compared with control cells. GM-CSF mRNA expression was more rapidly induced in cocultured cells compared with HBECs or AMs alone. The concentrations of TNF-alpha, GM-CSF, IL-1beta, IL-6, and IL-8 in the cocultured supernatants collected after 24 h PM(10) exposure increased significantly compared with control cells. There was a significant synergistic effect between AMs and HBECs in the production of GM-CSF and of IL-6 (P < 0.05). Instillation of supernatants from HBECs cultured with PM(10) into lungs of rabbits failed to increase circulating band cell counts or stimulate the bone marrow. However, those from AM/HBEC cocultures exposed to PM(10) increased circulating band cell counts (P < 0.05) and shortened the transit time of polymorphonuclear leukocytes (PMNs) through the bone marrow compared with control co-cultures (P < 0.01). These results suggest that the interaction between AMs and HBECs during PM(10) exposure contributes to the production of mediators that induce a systemic inflammatory response.

Particulate air pollution induces progression of atherosclerosis

ObjectivesWe sought to determine the effect of exposure to air pollution particulate matter <10 μm (PM10) on the progression of atherosclerosis in rabbits. BackgroundEpidemiologic studies have associated exposure to ambient PM10with increased cardiovascular morbidity and mortality. We have previously shown that PM10exposure induces a systemic inflammatory response that includes marrow stimulation, and we hypothesized that this response accelerates atherosclerosis. MethodsWatanabe heritable hyperlipidemic rabbits were exposed to PM10(n = 10) or vehicle (n = 6) for four weeks, and bone marrow stimulation was measured. Quantitative histologic methods were used to determine the morphologic features of the atherosclerotic lesions. ResultsExposure to PM10caused an increase in circulating polymorphonuclear leukocytes (PMN) band cell counts (day 15: 24.6 ± 3.0 vs. 11.5 ± 2.7 × 107/l [PM10vs. vehicle], p < 0.01) and an increase in the size of the bone marrow mitotic pool of PMNs. Exposure to PM10also caused progression of atherosclerotic lesions toward a more advanced phenotype. The volume fraction (vol/vol) of the coronary atherosclerotic lesions was increased by PM10exposure (33.3 ± 4.6% vs. 19.5 ± 3.1% [PM10vs. vehicle], p < 0.05). The vol/vol of atherosclerotic lesions correlated with the number of alveolar macrophages that phagocytosed PM10(coronary arteries: r = 0.53, p < 0.05; aorta: r = 0.51, p < 0.05). Exposure to PM10also caused an increase in plaque cell turnover and extracellular lipid pools in coronary and aortic lesions, as well as in the total amount of lipids in aortic lesions. ConclusionsProgression of atherosclerosis and increased vulnerability to plaque rupture may underlie the relationship between particulate air pollution and excess cardiovascular death.