Exacerbation with granulocyte colony-stimulating factor of prior acute lung injury during neutropenia recovery in rats.

Abstract:

OBJECTIVE:Neutropenia recovery may be associated with an increased risk of respiratory function deterioration. A history of pneumonia complicating neutropenia has been identified as the leading cause of adult respiratory distress syndrome during neutropenia recovery in patients receiving anticancer chemotherapy, suggesting that neutropenia recovery may worsen prior lung injury. DESIGN:Controlled animal study. SETTING:Research laboratory of an academic institution. SUBJECTS:Male Sprague-Dawley rats. INTERVENTIONS:We studied the effect of recovery from cyclophosphamide-induced neutropenia on endotoxin (lipopolysaccharide)- or hydrochloric acid-induced acute lung injury in rats. We also studied the effects of adding granulocyte colony-stimulating factor. MEASUREMENTS AND MAIN RESULTS:Compared with noncyclophosphamide-treated rats, rats undergoing neutropenia recovery had a higher wet/dry lung weight ratio after hydrochloric acid-induced but not lipopolysaccharide-induced acute lung injury. Granulocyte colony-stimulating factor significantly increased both alveolar cell recruitment (bronchoalveolar lavage fluid counts) and pulmonary edema (wet/dry lung ratio) in both acute lung injury models during neutropenia recovery. Furthermore, in an experiment in hydrochloric acid-instilled rats, exacerbation by granulocyte colony-stimulating factor of hydrochloric acid-induced acute lung injury was inhibited by lidocaine, which prevents adhesion of neutrophils to endothelial cells. Tumor necrosis factor-alpha and interleukin-1 beta concentrations in supernatants of lipopolysaccharide-stimulated alveolar macrophages from rats undergoing neutropenia recovery with granulocyte colony-stimulating factor treatment were significantly increased compared with rats undergoing neutropenia recovery without granulocyte colony-stimulating factor. CONCLUSION:Neutropenia recovery can worsen acute lung injury, and this effect is exacerbated by granulocyte colony-stimulating factor.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Azoulay E,Attalah H,Yang K,Herigault S,Jouault H,Brun-Buisson C,Brochard L,Harf A,Schlemmer B,Delclaux C

doi

10.1097/00003246-200301000-00025

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

157-65

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

31

pub_type

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