PURPOSE: Neutrophile elastase has been reported to play an important role in causing acute lung injury (ALI) which is a major cause of a post-operative mortality. It is secreted by the lung tissue into the blood, diffused into the peripheral circulation through the pulmonary vein, and is then degradated within several minutes. The aim of the present study was to compare the neutrophile elastase activity in pulmonary vein blood, which can be collected during pulmonary operation, with that in conventional peripheral blood, and to determine whether or not any change in activity occurs in the pulmonary vein blood perioperatively.
METHODS: In 10 patients receiving lobectomy with lymph node dissection, 4 parameters (neutrophile elastase activity, TNF-alpha, IL-6, IL-8)of blood from the pulmonary vein and from peripheral blood before and after the surgical procedure were measured. Then the parameters for the pulmonary vein were compared with the parameters for the peripheral blood.
RESULTS: All parameters except TNF-alpha were high in both the pulmonary vein and in the peripheral blood after surgical procedure. The peripheral IL-6, pulmonary IL-6, and peripheral IL-8 were each significantly higher postoperatively. There was no significant change in the neutrophile elastase activity, IL-6, or IL-8 in the pulmonary vein blood compared to these in the peripheral blood, there was a tendency to be higher.
CONCLUSION: Among the 10 patients receiving pulmonary surgery, an increase in neutrophile elastase activity, IL-6, IL-8 in pulmonary vein blood after pulmonary surgery tended to show an increase.
CLINICAL IMPLICATIONS: Since the findings suggest that neutrophile elastase activity in the pulmonary vein blood rises perioperatively, then a subsequent study may be warranted to discover if this increase can be restrained by adenocorticosteroid, neutrophile elastase inhibitor. Administration of this adenocorticosteroid, neutrophile elastase inhibitor may prevent patients from dying by ALI after pulmonary surgery.
DISCLOSURE: Norman Kimura, No Financial Disclosure Information; No Product/Research Disclosure Information